MediClaim Module Quick Guide - Randstad India€¦ · MediClaim Module Quick Guide Version 1.0 This document will guide you through how to reimburse/claim the medical expenses using

MediClaim Module Quick Guide Version 1.0 This document will guide you through how to reimburse/claim the medical expenses using the Mediclaim Module.

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Mediclaim Module Page 2 of 17

Contents

1 Introduction .................................................................................................................................... 3

2 Getting Started................................................................................................................................ 3

2.1 Add New Claim ........................................................................................................................ 6

2.2 View the Claim Details ........................................................................................................... 14

2.3 Shortfall Document ............................................................................................................... 14

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1 Introduction

This document describes about the process of claiming the medical expenses using the new

mediclaim module.

2 Getting Started

You can access the mediclaim module from the ESS application. Follow the instructions to access

the mediclaim module and process the claims.

1. Open the ESS web application. The ESS Login Page is displayed.

Enter the username and password. Click sign in.

2. The ESS employee information page is displayed.

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Click the medical e-card no. link.

3. The Dashboard home page is displayed in the mediclaim module.

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The dashboard displays the Help Document for your reference.

4. Click the Claims link.

5. The Claims listing screen is displayed.

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2.1 Add New Claim

Follow the steps to create a new claim.

Step 1: Click "Click To Create New Claim"

Step 2: Fill all mandatory fields in the "General "section. (Mandatory fields are marked in *)

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Claim Type: Choose "Self" for claiming mediclaim for self or "Dependent" for claiming for dependents.

Admission Date: Choose the date of admission and time.

Discharge Date: Choose the date of discharge and time.

Hospital Name: Mention the name of the hospital.

Step 3: Click Next button in the "General"section.

This action will navigate you to the next section "Upload Documents", provided all the mandatory fields are specified.

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Step 4: Upload all the mandatory documents in the "Upload Documents" section

The files to be uploaded can be chosen by clicking the Browse button or by dragging and dropping the files in the Drop files here box.

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To download a claim form, navigate/go to the "General" section. Under the Insurance Details tab, click the here option. By clicking this option, the user will be re-directed to the website of the insurance company from where the claim form can be downloaded.

Step 5: Choose Bill Heads under Details of Amount Claimed and upload the necessary document. Choose the Bill Head, mention the Bill No, Date, Bill Value.

To add another Bill Head, click on the button.

To save the details, click the Save button.

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Step 6: Click Next button in the "Upload Documents" section

This action will navigate you to the next section "Review", provided all the mandatory fields are specified.

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Step 7: Update the Courier Details

Click the Here option in the Courier Details box to update the courier information.

(i) Choose the Company from the drop down list.

(ii) Mention the Courier Docket No.

(iii) Mention the Location.

(iv) Specify the Couriered Date.

(v) Select the documents that are being couriered.

(vi) Click the Next button. The courier details will be saved.

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Step 8: Review all the uploaded documents and click the Finish button.

Note: The Finish button will be enabled only when all the necessary documents have been uploaded and the courier details are mentioned.

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On clicking the Finish button, a confirmation message will be shown. This completes the creation of a new claim.

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2.2 View the Claim Details

This section explains how to view the newly added claims.

1. Click on Claims menu. The listing screen will display all the claims with their statuses. The new claim will have the status stamped as APPLIED.

2.3 Shortfall Document

Shortfall documents are those which are not submitted by you, which is mandatory for further claim process. This section explains how to view the list of those shortfall documents.

Step 1: To view a Shortfall document. Click Claims menu. A Shortfall document will be indicated by the status Shortfall.

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Step 2: Open the Claim with the status marked as Shortfall. Click the Claim Code. This will open the claim.

Step 3: Upload the necessary document by choosing the file using the Browse option or by dragging and dropping a file in the Drop files here box.

Step 4: Update the courier details by clicking the here option.

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Step 5: Specify the courier details and click Next button.

The newly added courier details are listed under the Courier Details tab.

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The Shortfall document will be verified by the TPA for further processing.