Reimbursement Form

Reimbursement Form

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Dear Member,

In order to facilitate prompt settlement of your claims, MedNet is providing the option of submitting your cash (reimbursement) claims online. Alternatively, please contact your Insurance Company or the relevant department in your organisation for other modes of submission.

Mandatory Requirement for settlement of Cash (Reimbursement) Claims:

For the settlement of Eligible Expenses, You should submit the following documents to us within a maximum period of 60 days for claims incurred within the country and within 90 days for claims incurred outside the country from date of treatment:

  • Completed Reimbursement Form from the treating Doctor
  • Itemized receipts of payment for the amount claimed (The invoice must show cost per service)
  • Full and Detailed Medical report / Diagnosis / Discharge Summary from the treating Doctor
  • Personalized SOAP if applicable
  • Copies of Results of Diagnostic Tests

Please click the link below to submit reimbursement claim

Click the link below