UnitedHealthcare Parekh Insurance TPA (UHCP) is a preferred TPA in the health insurance industry specializing in a wide range of health service offerings. UHCP is a joint venture between the world’s leading health insurance company, UnitedHealth Group and the Parekh family.
Read on for a detailed explanation of UnitedHealthcare Parekh’s claim process with information on the documents required and other intricacies of claim submission.
Know Your Customer (KYC) documents verify and establish the identity of the patient and the policyholder. These documents include the following:
- A copy of patient’s Aadhaar card
- A copy of policyholder’s PAN card (If PAN card is unavailable, any other government-issued ID proof may work)
- UnitedHealthcare Parekh or the insurance policy certificate
- A cancelled cheque (original) for policyholder’s banking account details
Generate your UnitedHealthcare Parekh (UHC) TPA E-card here.
Hospitalization and Treatment Documents
Along with your claim form, you need to submit the documents such as discharge summary, payment receipts, hospital bill, package breakup, bill breakup, etc. you receive from the hospital. These documents have to be in original printed on the hospital’s letterhead. While collecting the documents from the hospital, go through these checkpoints:
- The main hospital bill is usually a summary of all the expenses. Ask the hospital for a breakup of the bill.
- If your hospital bill includes a surgery package, ensure that you ask for the package breakup printed on the hospital’s letterhead or a plain paper with the hospital’s seal.
- Receipts of all payments you made to the hospitals needs to be included in your claim. So, ensure that all the receipts amounts match the final bill amount, after deducting the discounts, if any.
For pre-hospitalization and/or post-hospitalization claims, you don’t need the hospital bills or the breakups of the bill. A photocopy of discharge summary is all you need to submit such claims.
Remember to include consultation, physiotherapy, pharmacy, and lab bills in your claim. Ensure that you check the duration eligibility of pre and post-hospitalization. Make sure that your pre and post hospitalization claims need to have all the bills in the original.
Include the doctor prescriptions (in original) as supporting documents to all your pre and post-hospitalization bills you are attaching with your claim. Otherwise, UnitedHealthcare Parekh may not pay for those expenses.
Your lab investigation reports and scans billed by the hospital have to be reconciled with your reports. So, examine them carefully. Ensure you have all the reports in original. That means the reports have to be printed on the hospital’s or the lab’s letterhead. A report on a plain paper with just the hospital/lab seal may not be accepted by UnitedHealthcare Parekh.
If you miss including any of the reports, UnitedHealthcare Parekh may subtract that amount charged for those investigations or it may raise a query asking you to submit those reports. If you don’t have any reports available, the best thing you could do is add a cover note while filing your claim. The cover note may include a date-wise list all the reports you won’t be submitting because you don’t have them.
For pre and post-hospitalization claims, ensure all investigation/lab bills are supported with the investigation reports. Ensure that each of these reports is backed by the doctor’s prescription on their letterhead or a lab requisition slip. Most claimants make mistakes in this step, because of which they lose a lot of money in their claim.
Accident Details, if Applicable
For accident-related claims, there are additional documents required. Medico-legal Certificate (MLC) from the hospital where treatment was taken and an FIR copy if the accident was reported to the police.
If the accident is due to self-injury, include a letter explaining the details of the injury. Make sure that the letter is signed by the injured person. Self-injury could mean a case of getting hurt while playing or a self-fall.