Precautions & Procedure of Claiming Medical Reimbursement Charges

Medical Reimbursement Charges is the amount that is claimed by the Govt Employee due to the illness or disease of his family, parents or himself. Although the process of claiming Medical Charges is somewhat difficult, however if the following rulings be kept in mind then this process can be made easy.

  1. “Typed Application” of the claimant regarding reimbursement of medical charges showing name of hospital, disease & patient with relationship be attached with the case.
  2. Medical proforma must be signed by the employee & the concerned authorities & countersigned by Civil Surgeon/Medical Superintendent (with name stamp).
  3. Dependent certificate clearly showing age and relationship duly verified by the Controlling Officer must be attached with the claim.
  4. In case of reimbursement of expenditure incurred on treatment of parents (Father/Mother) of the Govt Employee, certificate regarding “Wholly Dependent  upon the Govt Employee duly signed by the employee and the Head of the institution be attached.
  5. Name and quantity of medicine should be clearly shown on the prescription slip.
  6. Cash memo No., date, name of chemist, quantity and cost of medicines shown in cash memos/vouchers are clearly shown on medical claim proforma.
  7. Cash memos issued by the chemist/medical stores must be on proper printed form with printed license No. of the chemist and duly signed/stamped by the authorized medical attendant.
  8.           Cost of the medicines shown in cash memos/vouchers should be correctly entered in the medical claim proforma.
  9. History treatment card of the patient on printed form of the hospital be attached.
  10. Original Prescription Slip/Certificate duly written on the printed pad of the hospital concerned bearing O.P.D No., Name, Age, Sex and disease/diagnoses of the patient duly signed/stamped by the treating doctor and original admission/discharge certificate (in case of indoor treatment) duly signed/countersigned by the treating doctor & Civil Surgeon/Medical Superintendent respectively be attached.
  11. In case the patient is referred to some other hospital by the authorized Medical Attendant of such referral letter/move sanction, as case may be, be attached with the claim.
  12. If any patient is got treatment from any unauthorized/private hospital/clinic in emergency, an “Emergency Certificate” on printed pad of the treating doctor showing nature of disease and treatment given, duly signed/countersigned by the treating doctor (with by name stamp) & Medical Superintendent /Civil Surgeon (with by name stamp) will be attached with the claim.
  13. If any patient is got treatment from any unauthorized/private hospital/clinic in emergency, “Distance Certificate” clearly showing the distance from the residence to authorized and unauthorized hospital duly signed/countersigned by the Govt Servant & Head of the Institution be finished.
  14. The claims of Medical Reimbursement are only allowed in case of Accident or Extreme Emergency.
  15. In case of medical reimbursement expenditures occurred on family members (wife, husband, children or parents) attested copy of CNIC or form ‘B’ issued by NADRA be attached with the claim.
  16. In case of medical re-imbursement expenditures occurred on spouse or children above 18 years of age their “Status Certificate” showing whether they are Govt Employee or otherwise may also be attached.
  17. Only one original copy of the case be submitted to the higher authorities the other copy be kept by the office of the employee.
  18. The case must be submitted to the higher authorities within the 60 days of discharge of patient.
  19. Cost of Unani. Ayurvedic and Homeopathic medicines cannot be included in the claim bill.
  20. Transportation charges of the patient are not to be included in the claim.
  21. Cost of laboratory tests taken from authorized/unauthorized hospital/laboratory is admissible on the basis of reference by the Authorized Medical Attendant only.
  22. Cost of vaccine (s), blood and products is allowed.
  23. The cost of the following items is not admissible:
  •           Cost of organs and tissues in case of transplant.
  •           Soaps and Detergents
  •           Food Supplements
  •           Toilet and Cosmetic Goods
  •           Thermometer
  •           Expenses incurred on medical treatment abroad

24.  The cost of the following items is reimbursable:

  •           Antiseptic Liquids as prescribed
  •           Disposables as prescribed

25. “Dental treatment” includes treatment of alveolar (gum and jaw bones) diseases, extraction of teeth, treatment for dental caries, gingivitis, pyorrhea and filling temporary or permanent) of dental cavities including root canal treatment, sealing, but does not include dental implants, orthodontic application, bridging, crowning and provision of dentures.

If you follow the above mentioned claims processing for medical reimbursement, you will have to face no difficulty.

 

30 Comments

  1. M Faheem says:

    Maim , i m bps 14 frm balochistan .. I need medical charges reimbursement policy of Govt of balochistan . My wife underwent Cesarian operation in hospital for baby birth. Kindly support with concerned all documents.

    faheemahmed4455@gmail.com
    thanks

  2. Hamid Ullah says:

    AoA
    The wife of the Punjab Govt. Officer (BS-16) was ill and went to Tehsil Headquarter Hospital, Chunian. The Authorized Medical Attendant, THQ, Chunian referred the patient to the ANMOL Hospital, Lahore being a Cancer case. The treatment of the patient was completed at ANMOL Hospital, Lahore and an expenditure of more than Rs. 0.200 million was incurred.
    Please guide us whether the Punjab Govt. Officer can claim the reimbursement of Rs. 0.200 million, whereas the ANMOL Hospital, Lahore is a Central Govt./Atomic Energy Commission Hospital. If yes, please provide any Punjab Govt. Notification/Rule etc.

  3. M.Imtiaz Ali says:

    Kindly provide me the following letters readable copies regarding reimbursement of medical charges

    No.FD.PC-2-2/2010 dated 15-7-2010

    No.FDSR-1-1-78/2010 dated 3-12-2012

    thankx

  4. Raza says:

    Respectfully, You are doing great work.
    I need medical charges reimbursement policy of Govt of Punjab. My wife underwent Cesarian operation in hospital for baby birth. Kindly support with concerned documents.
    Regards.

  5. Inam says:

    The case must be submitted to the higher authorities within the 60 days of discharge of patient.
    have you any ruling / notification regarding the above matter?

    plz. guide

    thanks & regards

    attnn: ShumailaKamal

  6. Nadeem Ahmad Awan says:

    Mam!
    The federal govt. officers from B-16 to 22 are entitled to re-reimbursement of expenses incurred on diagnostic investigation and consultation at OPDs. Whether the employees from B-1 to 15 are also entitled for this facility or otherwise?

    Plz clarify with relevant Notification/O.M. No.

  7. Waqar Ahmad says:

    Kindly sent me the proforma of Distance Certificate at my email address

  8. zahid says:

    aoa.

    plz tell me whether there is any upper ceiling (financial ceiling) of indoor medical treatment claim in any provincial or federal department or armed forces?

  9. prof.khalid says:

    Hi
    i am in grade 17. i am patient of ankyloosing spindilitis. dr.'s saying that i need injections weekly for 6 month. (Cost 6,000000)
    dear there is any way that govt compensate me before treatment. i now that medical claim will be due after treatment. but i have not enough money at the moment. pls reply soon

  10. rana amer mahmood says:

    i want to know how is sanction authority of medical reimbursement cases of retired persons in district governments while no any department have budget for pensioners?

  11. Raza says:

    I need to know that whether a contract employee can also claim the medical reimbursement especially for a By Pass Operation (Cardiac Surgery)? Please reply early as the patient is going to be operated on 15th of this Month....

    Thanks.

    • ShumailaKamal says:

      Dear Raza, not confirm. I think it is for all employees. If an Contract employee can get Medical Allowance then why he cannot claim medical re-Imbursment?

  12. ali says:

    i am ali in grade 16 employee of Pakistan audit department. i am pleased to clarify that in case of emergency, in private hospital, is anesthesia fee, ICU operative charges and theater charges is admissible for reimbursement or not please guide me with the reference of rule if admissible or vice versa,

  13. Iftikhar Hussain says:

    Please sending the latest rule of medical reimbursement issued by the concerned quarter

  14. Iftikhar Hussain says:

    I am in grade 16 employee and enjoying the facility of medical allowance Rs. 1000/- per month. Whether I submit the medical claim or not , pleae reply.

    • Dear Iftikhar u can surely claim the Medical Re-Imbursment.

      • ZAMEER from bwn says:

        dear shumaila kamal shiba, District Government main 50000 to above to 01 lac DCO Sb authority hain Medical reimbursement main only powers delegated hain retired/in service and contract etc shamil hain. thanks

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