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Asso.prof.(commerce & Management)

Dear sir, I have prescibed for my wife meternity in pvt hospital during lockdown because our ESIC hospital near me converted to a COVID 19 hospital, so how can I get my reimbursement of bills from ESIC, i am insured in ESIC.
From India, Noida
Hi AmitC,

Pl.try to submit it to the ESIC hospital and see what happens.

You have to submit a reimbursement claim bill/bills as an IP, write an application to the Administrative Medical Officer, ESI Scheme, in the place of treatment had through the concerned Insurance Medical Officer i/c, ESI Scheme Dispensary allotted to the employee along with the claim bill format which is available at Dispensary. They have to mention the cause of diseases and the reason for diverting to a Pvt.hospital.

Did you get the prior approval before admitting your wife in a Pvt.hospital? Is this pvt. hospital among the list recognized as referral hospital by ESI hospital for such treatment? Was this an emergency or not so ? Better approach the concerned Medical Officer/office for proper guidance to apply for reimbursement in the form.

Also go thru' the stipulations/regulations for 'reimbursement of claims' ref:ESIC.

From India, Bangalore

Attached Files
File Type: docx ESI-Norms for Reimbursement.docx (16.9 KB, 11 views)

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