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This document serves as a checklist for reimbursement of medical claims under the Central Government Health Scheme, detailing submission requirements and various sections to fill out by the applicants.
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How to fill out CENTRAL GOVERNMENT HEALTH SCHEME MODIFIED CHECK LIST FOR REIMBURSEMENT Of MEDICAL CLAIMS‐2004

01
Obtain the CENTRAL GOVERNMENT HEALTH SCHEME MODIFIED CHECK LIST for REIMBURSEMENT Of MEDICAL CLAIMS‐2004 form.
02
Fill in the details of the applicant, including name, designation, and department.
03
Provide the details of the medical claim, including the type of treatment and hospital where treatment was received.
04
Attach necessary documents such as medical bills, discharge summaries, and prescriptions.
05
Ensure that all fields in the checklist are completed to avoid delays.
06
Review the completed checklist for accuracy.
07
Submit the checklist along with all supporting documents to the designated health office.

Who needs CENTRAL GOVERNMENT HEALTH SCHEME MODIFIED CHECK LIST FOR REIMBURSEMENT Of MEDICAL CLAIMS‐2004?

01
Government employees and pensioners who have incurred medical expenses.
02
Family members of government employees who are covered under the CENTRAL GOVERNMENT HEALTH SCHEME.
03
Individuals seeking reimbursement for medical claims under the scheme.
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The CENTRAL GOVERNMENT HEALTH SCHEME MODIFIED CHECK LIST FOR REIMBURSEMENT Of MEDICAL CLAIMS‐2004 is a guideline document that outlines the necessary steps and requirements for government employees and their dependents to claim reimbursement for medical expenses under the Central Government Health Scheme.
The check list is required to be filed by central government employees and their eligible family members who seek reimbursement for medical claims under the Central Government Health Scheme.
To fill out the check list, beneficiaries must provide personal details, details of the medical treatment, attach relevant medical bills and documents, and ensure all required fields are completed accurately as per the guidelines given in the document.
The purpose of the check list is to ensure that all necessary documentation is submitted for processing medical claims and to streamline the reimbursement process for eligible beneficiaries.
The information to be reported includes personal information of the claimant, details of the medical treatment received, bills and receipts from the healthcare provider, and any other documentation that verifies the claim.
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