Medical claim forms

Today medical facilities have become so expensive that it has become an out of reach question for many common people. In order to cope up with the sky-rocketing medical expenses, people have started taking medical claims, which cover and provide them financial assistance during their difficult times. There are various private as well as government owned insurance companies present in the financial market, which serves people with the same.

Hence, medical claim forms do form a very important part of today’s medical billing procedure as this includes submission as well as follow-up of the medical claim forms with the concerned insurance companies. The health care unit serving the patient submits the medical claim forms of the patient to the insurance companies to receive payment from them on behalf of the patient for all the medical assistance provided by them.

Hence, we can also term the medical billing procedure as dealings between the patient’s health care unit and the insurance company from which the patient has taken a medical claim. This whole interaction basically depends upon the medical record of the patient. This record is created by the health care providing unit under which they maintain a detailed summary of the patient’s whole treatment including the patient’s concerned information with his policy number, policy company name etc.

Usually upon the patient’s first visit to the health provider includes a number of diagnosis enabling the provider to better understand the condition of the patient. The patient’s medical record also summarizes personal information about the patient like the illness structure, all the examination details, medication suggested, diagnoses report, and suggested treatment etc.

Medical claim forms that are submitted by the health care providing unit to the insurance companies are of various types. Such as, medical expenses claim forms, medical mutual claim forms, uniform medical claim forms, etc.

There are some basic formalities, which are to be completed prior submission of medical claim forms to the insurance companies, these includes:

1. Some medical claims provide a financial cover only to a single patient at a time. So, in order to avoid any hassle, these claim types should not be used for mutual patient coverage
2. Along with these medical claim forms, the health care providing unit is also required to attach all the itemized bills of the treatment provided to the patient.
3. Also the proof of the services rendered i.e. the bill detailing the patients name, period of services rendered, diagnosis undertaken along with the charges of same etc.


Medical claim pdf forms also put a restriction to the limitation of the services covered under the same. Few examples of which are mentioned below:

* Acupuncture: The medical claim covers only 60 visit/year, the services that provide an aesthetic treatment or a pain reducing treatment to the patient.
* Ambulance: The facilities offered and the specialist services provided are excluded from the coverage of medical claims and hence are charged separately to the patient.