Maternity claim Mediassist || Maternity claim by both parents || Claim one bill using two policies

[@IshantSharma-g9t]

Thank you so much brother, for sharing this detailed information.

[@kapilpawankar2662]

Hi Brother, Thank you so much for the valuable information. My case is more or less similar to your case only. We both work at different companies but our TPA is same (FHPL) and the hospital i am planning falls under network hospital so we both have different limits/caps (75,000 & 50,000) for maternity and since its a network hospital on both policies there is a benefit of cashless reimbursement. So my question is how should i proceed in this case where both are cashless so I think there is no first or second claim. I think I have to submit both policy details at the same time. I mean I dont know the details of it so request you to please guide how can I get the maximum benefit in this case.

[@Mr1991AY]

Very Helpful video.Thank you for that first. Me and my wife both have insurance through our Organizations. Delivery of my baby is done in non-network hospital. - If I will submit original bills how will my wife claim as original bill will be required. - can I ask 2 set of bill from hospital? - If yes, how should I ask hospital to generate it any idea about it?

[@biswa012]

Keep xerox copies. In this video I mentioned that you need to provide settlement note of first claim. This means you have already claimed and asking for differential. Bill I don't think you would get 2 copies unless there is any app for that hospital that allows you to download bills. If it is then download and get them stamped(not on same day obviously :))

[@parthapratimdparth]

Thanks for all the information you have provided. I and my wife both working in the same company. In the video you have given a theory that both will get the claim as company is paying indovidually for both. Which is absolutely correct. But please advise do you have any case like this in your knowledge. That husband and wife both working for same company and both getting maternity claim. Thanks

[@sayantanisdiary6254]

It depends on the policy. I know of a couple from TCS who were not allowed to claim twice.

[@RaviGaikwad-f1l]

I have one question if me and my working in different organisations can we claim for both organisation

[@HarshSharma-lp5ul]

Very Informative !! Thank you

[@Quirky_vlog]

Hello sir, thank you for the information it's really valuable I have a doubt can me and husband who works in different firm can claim maternity insurance from same health insurance company or TPA?

[@sayantanisdiary6254]

I am glad that you found the video helpful 🙏 Yes you both can claim insurance from the same TPA.

[@AkshayGupta108]

thanks.. this is exactly my question

[@dsumit4u]

much needed information.... thank you so much for sharing

[@Live_Loud]

I have exactly same case like yours. Can I claim pre & post maternity claim in Bajaj allianz & delivery charges(main bill) in new india assurance(cashless)? Both mediclaims have the hospital in network. Do I have to fill form from hospital even just for pre and post hospitalization claim?

[@biswa012]

For pre and post care you don't need Form B. However, I would suggest first get the cashless done and say the expense is 100 and approved is 50. Your pre and post is 20.Then apply for second one as reimbursement. There claim 100+20-50 this way. If you claim only pre and post without the actual delivery related papers then high chance it will be rejected.

[@harsha555]

@@biswa012 i have almost same situation now, i got cashless benefit for delivery, but now I need to claim pre hospitalization expenses like scan n doctor visit charges, so do I need to get form B filled by hospital?

[@biswa012]

@@harsha555 If you are not claiming anything related to hospitalization then you don't need Form B. But this is interesting question. I am not sure if you can claim only pre hospitalization charge for a maternity reimbursement. What I did I added pre and post hospitalization bills along with main hospital bill and went for reimbursement with a Form B. In this claim I attached previous settlement copy. For your case you already had cashless so your hospital bill will show the discount. Ideally you should get one Form B and send all bills for reimbursement (pre, post and in hospital). They will consider the total amount minus previously settled amount

[@Live_Loud]

@@biswa012 hi I came here again as I want to provide the update. I'm blessed with twin baby girls. The expenses for C section delivery were 40k only so it got settled in single claim. Now I want to claim pre and post hospitalization expenses on another policy as my wife's policy didn't support Pre and post expenses. My policy is denying to support only pre and post maternity expenses. Do you have any solution on this?

[@biswa012]

@@Live_Loud claim pre, post and hospitalization all and attach settlement note for first claim.... This way they will approve pre and post hospitalization cost and ignore delivery cost as it's already settled.... Technically they are right. Without hospitalization they may deny pre and post fee only.....If you tell upfront you are going to do this then for sure they will say No as they don't want pay ... Raise entire claim and let them get back with clarification that time you can tell them to exclude hospitalization cost and approve rest. Congratulations on your news... Welcome to the new world of parenting! God bless your twins.

[@parnachanda2100]

Very informative… thank you so much

[@kanishkabajaj5335]

What if bill differs for 2 insurance company , which insurance should be used first?

[@biswa012]

One with maximum limit should be consumed first

[@ravitejakatari1986]

If husband has insurance policy with maternity cover for spouse from his employer and wife is also employed and having insurance and during maternity delivery Husband or wife can go for cashless and other can go for reimbursement . Note : Always intimate to TPA within 24 hours of admission Always pay by debit card or credit card .

[@biswa012]

Yes they can

[@Bhaskar-jg1jk]

If husband and wife both are employees and don't have cashless option then they can avail both reimbursement? Pls reply urgent?

[@ravitejakatari1986]

​@@Bhaskar-jg1jknot sure about your scenario .Better check with your insurer about your scenario.

[@lamps820]

Thankyou for this video.It was very helpful. I have another question.Me and my wife’s policy is the same which is New India assurance company under MediBuddy.Is is enough if my wife’s company can send the claim number to my company if I have to claim the excess amount beyond 50k or I have to claim the reimbursement from my system by submitting all the documents.Thanks!

[@biswa012]

No you have to apply separately. As insurance provider they would always want to pay less so dont expect at all that they will make second claim on your behalf :).... After first claims settles, please apply second claim yourself as I mentioned in the video

[@swatisingh703]

Very useful info.. Tnx for sharing!!

[@debaratichakraborty1479]

Thanks but is there any specific insurance which supports maternity benefit? Or from any insurance we can claim? Plz answer this

[@biswa012]

Usually for any health insurance has maternity coverage but please read your paper or check with your agent for specific details like limit and others

[@thirudravid2701]

Sir, I have a doubt could you pls solve that... Actually I have question that if my daughter gets married whether she is eligible to get maternity expense under my policy. As she have name in my insurance policy.

[@sayantanisdiary6254]

If your policy permits your married daughter to be registered as your dependent then yes but this is unlikely. Please check with your agent.

[@naziyapatil2864]

Thank-you so much for such detail information

[@D07792]

I have corporate group insurance. I haven’t claim maternity claim for the first child. I claim led in insurance for the 2nd claim delivery expenses. Am I eligible for the claim for delivery expenses of the 3rd child I am allowed to claim two times for maternity expenses. But now all have 3 living children now

[@shreyasihazra]

How much time does it take to get the claim settlement letter for the 1st cashless benefit?

[@sayantanisdiary6254]

20 days to 1 month.

[@shreyasihazra]

@@sayantanisdiary6254 in that case, if it takes a month, how did you claim for reimbursement from the 2nd insurer (assuming the post hospitalization claim to be taken within 30 days)? Is there any process or do we need to provide any letter beforehand to the 2nd tpa? Note: both the tpa are same.

[@sayantanisdiary6254]

You will have to follow up with the first claim continuously.... So that 2nd claim can be done within 30 days.

[@shreyasihazra]

@@sayantanisdiary6254 thanks much for the response and also the much detailed insightful video

[@ajuece19]

Hi Sir, This is the most informational timely video i have seen so far :) Kudos to your effort. It was to the point. I am currently expecting my second kid and planning to claim as you suggested. Me and my wife , both working in different companies with the same TPA (MediAssist / Medibuddy). The insurance provider is same for both. Its New India Assurance. Is it fine to do the process you said despite the insurance provider being the same for both of us?

[@sayantanisdiary6254]

Thank you. Yes you can follow the same process.

[@biswa012]

Yes for us also it was medibuddy/national insurance combo so shouldn't be a problem for you as well.

[@ajuece19]

@@biswa012 Hi Brother. Need your help. Can you provide your email id or phone number so that i can talk to you directly?

[@supritkumarsahu997]

Could you please inform if there is a co-pay (25percent)for 2nd insurance,how they will calculate? Let's say if 1.1lakh is the final and both the insurance have 50k capping for maternity cover.Here 50K got settled as cashless ,another 60K was claimed for reimbursement.assume 10K wont be considered as non surgical item , then will I get 50K or 25 percent of 50K ?

[@biswa012]

25% co pay means you have to pay 25% …. It’s calculated after removing all deductibles like surgicals… assuming your eligible amount is 50K after deductible then 37.5K you will get and 12.5 you need to co pay

[@sunnypandey1777]

It was still Little confusing from the video hope I get better understanding when I start the process

[@mangatinanda]

We have two insurances both cover 50K as maternity benifit... Oriental with Vidal health TPA and ICICI Lombard. We went with Cashless for Vidal health. For going with reimbursement for icici, should I get the part b form filled by the hospital?

[@sayantanisdiary6254]

Yes

[@mangatinanda]

Due to some maternity related complications, mother is kept in semi ICU for more than 7 days... the bill is now going above 1.8L... To claim complications related treatment expense, insurance people are asking for two discharge summaries one for maternity and the other for complications... Hospital is not agreeing for that as they have only admitted the patient once. I have mailed the but no response yet. Any advice here?

[@biswa012]

You may not get 2 discharge summary as patient is discharged only once..... You could get a recommendation written by doctor where it's explicitely mentioned about those complications and advice to extend the stay and treatment

[@thirudravid2701]

@@biswa012 hey I have a doubt... Could you pls solve that!

[@NehaSingh-ph7yb]

​@@biswa012Hiii sir my husband and I work for the same company and we both have the same insurance company which is Medi Assist can we both claim in our insurance and get our Medical bills reimbursed????

[@sravangoud3427]

Do we cliem for 3rd pregent? All ready i have 2 kids planning for 3rd kid

[@sayantanisdiary6254]

My company allows maternity claim upto 2 kids. You can check with your TPO.

[@sudarshankumawat8956]

Hi Sir, My spouse and me work in same company and covered by medi assist can we claim it twice

[@sayantanisdiary6254]

I have checked this with one of my friends in TCS.. They could not claim the insurance twice. You can check with your tpa.

[@prabalde7321]

Can I claim for the child after delivery my tpa medi assist

[@biswa012]

Yes reimbursement option is always open but claim within 15 days

[@MAHESHplk]

Thanks 🎉

[@thamilselvanofficial]

Hi,can i claim my company and my wife company i am from infosys my wife from another startup she is also have insurance for maternity?

[@sayantanisdiary6254]

Yes. First claim from one of the insurance which has more coverage for maternity. Once you get the claim settlement bill from first company.. You can claim the rest of the amount from the second company by submitting the claim settlement bill.

[@thamilselvanofficial]

@@sayantanisdiary6254 is it possible because that 2 bills are same ?

[@thamilselvanofficial]

@@sayantanisdiary6254 bro are you working in infosys ?

[@sayantanisdiary6254]

I did the same myself. Claimed first from my husband's company and remaining I submitted to Infy along with claim settlement bill which I received from husband's insurance.

[@jeevim206]

Hi sir, currently my plan shows ESIC in mediassit am I able to claim my reimbursement for the full amount.

[@prabhjotkaur4254]

Is there any limit of pre hospitalization time period if I am going for a partial claim through medi assist as i have already took cashless from my husband's insurance. When I have asked from medi assist they said for pre-hospitalization it is 8 months before date of delivery and 60 days for post natal... I have submitted for my reimbursement including pre+post+total bill from which I need to claim for 30k as my husband's insurance settled for 50k from the total bill of 90k out of which 10k was non medical... But looks like my insurance has only considered bills which are only 30 days from date of delivery all others they have mentioned out of pre- hospitalization boundry.. i appreciate your response on this thanks..

[@biswa012]

This is true... Typically 30 day pre delivery and 60 day post delivery is considered for bill. Final scan and medicines you can claim in pre delivery.

[@SagarPatil-gu5gp]

From whom a when I will get settlement note ?

[@sayantanisdiary6254]

From your first claimed settler after your claim is settled.

[@traveldiaries7889]

This is really helpful

[@greensgarden6487]

Can we claim for IVF treatment

[@sayantanisdiary6254]

Ideally yes. But please check the terms and conditions as per your policy.

[@urmilasingh5429]

Mere hispital wale cashless k bad jo access amount hai uske liye bill ni de rhe hai plz suggest kriye

[@SimarpreetSinghBagga]

I got to know that doc fees for delivery is partially paid through the hospital and is covered under policy and part of it we have to pay to doc. Can we claim that part payment done separately to the doc?

[@biswa012]

Get a separate bill for that part payment

[@soubhikkhankary2367]

Sir, how can i claim surgeon charges which was taken additionally on top of package!! I have got handwritten bill from the doctor. Do i need to attach the bill in hospitalization section in form part A? Please guide me. Thanks

[@biswa012]

Yes that bill u can attach in claim

[@ananyachaudhuri8191]

Hi need one help, I am also in same situation . Want to claim the surgeon charges. My tpa is mediAssist. Can you tell me if you successfully got the reimbursement and what all documents you had to attach?? mediAssist asking me for advice letter along with attested claim documents for another partial cashless claim that I avail from my husband tpa(i.e mediAssist only)

[@najeemabegums8719]

I sir how to fill forms I am not able to understand how to apply maternity claim charges in Infosys

[@biswa012]

You can take help from TPA to claim

[@VRPropertiesinfo]

Hi sir how to mention seperate surgeon charges for maternity claim

[@sayantanisdiary6254]

Our surgeon took cash and gave us bill which we could claim.

[@ananyachaudhuri8191]

My tpa is asking for breakup for this amount(surgeon charges). Have you faced this and what to do here?

[@ananyachaudhuri8191]

​@@sayantanisdiary6254 my tpa is asking for breakup of this surgeon charges. Have you faced this issue? My tpa is mediassist. Doctor only gave us a hand written bill

[@Vinaykovelakuntla]

Hi Sir, do we need marriage certificate, to claim both(mine and my wife's) insurances.

[@sayantanisdiary6254]

No.

[@rameshradder3039]

Me And my wife both are working in different companies but for same TPA and same insurance provider and we planned for non network hospital so can we claim from both insurance ? But even both of them are asking hard copies so how should I proceed as we will come under reimbursement policy.

[@biswa012]

Claim first with with higher value first. Then claim second one and share all xerox copies and original settlement note of first claim. There you should claim only the extra amount which was not settled in first claim. The they will process

[@AmolPatil-cw8lo]

Sir , I am working in certain company. Our company providing insurance for both of us through medibuddy. For maternity claim, can we claim bills twice through my wife and then me?

[@Bhaskar-jg1jk]

Have you done for twice? Pls reply urgent?

[@sayantanisdiary6254]

Yes from both my and my husband's company.

[@vipulboraseplantloverncycl7826]

Hi can Insurance company or TPA hold the claim amount as cashless facility was not used and we process it as reimbursement of Maternity claim. And what is the meaning of Hospital Discount in deduction part. Why there are being deducted from claim amount.

[@biswa012]

It's completely your choice if you would opt for cashless Or reimbursement. Cashless is a benefit but not mandatory. You can always go for reimbursement route. "Hospital Discount" I am not sure. You need to check with TPA what is that deduction for.

[@ireneshirlz1483]

Hello Sir, My husband and I are working in different organisations. Both organisations have TPA Mediassist. But for me its Oriental Insurance and for my husband is New India Assurance. The hospital we are planning for, is a GIPSA (Preferred Provider Hospital) which is not a network hospital under both insurers but it comes under TPA list of network hospitals. Is submitting two Reimbursement requests, the only option??

[@biswa012]

You can still cross check if cashless is an option for any of your policies. If not then yes you need to go for reimbursement sequentially. Go for higher value first.

[@rajulani6384]

I have 100000 lakh group insurance . Delivered baby network hospital. Total bill Is 65000.cash less benifit of maternity approved only 50000.balance 15000 not approved.baby bill including in total bill. I claim baby benifit. How to claim 15000.please send step by step.

[@biswa012]

If it a single policy number then you cannot claim under it even if it a group. First you confirm if you have 2 different policies or not

[@-Srividya-fw1gg]

What will happen if both claimed parallely? Can u please answer

[@biswa012]

You can send one original copy to one TPA at a time. So how did you claim in parallel?

[@sharankumar2440]

Hi , were you able to claim parallely??

[@sayantanisdiary6254]

No sequentially. After our first claim was settled we had to submit the settlement note for the second claim.

[@georgemitra8754]

If the hospital is a network hospital for both insurance policies, will it be possible to get the cashless benefit for both?

[@biswa012]

That's not possible. You have to settle 2 claims sequentially and not in parallel and only one cashless claim will be adjusted against the hospital bill. Second one you can reimburse as I mentioned in video

[@v_naymishra]

I work in Tech M and my TPA is mediassist. I had 1 lakh + expenses, 90k for wife and around 20k+ for baby (kept in NICU for 2 days) . How to proceed with claim ? Can I contact you somehow ??

[@biswa012]

Have you already availed cashless Or you will reimburse?

[@dastidarful]

Hi....Can I connect with you for better understanding?

[@lizamishra4144]

I have a personal National Health insurance policy can I apply fr maternity claim..pls guide

[@biswa012]

If your policy has maternity cover then yes you can claim.

[@sindhun5985]

If we go for cashless, hospital is not ready to fill form B. What to do in that case

[@biswa012]

Go after a week . Same day they won’t . While you go, just carry discharge certificate

[@PrabhatKumar-je2ot]

For me and my wife TPA is medi-assist and insurance company is also same i.e. new India assurance, we both work in different organization, Can i claim as cashless(Neotia Newtown) from my insurance and reimburse from my wife insurance and for reimbursement what are the documents we need to colly from the hospital? Thanks in Advance 🙂

[@biswa012]

Yes u can do this. You will get separate bills for mother and baby so take 2 copies of form B signed by hospital(mother and baby). While reimbursement you need to ask TPA whether you have to raise 2 claims Or not for mother and baby and claim accordingly for reimbursement.If baby claim has to be done separately then make sure you add your baby in your plan before you raise the claim. Hospital will give you all the documents like bills, discharge, reports etc. You have to upload copy of all these while you claim.

[@shivampandeysp7704]

Sir sizerian ka kitna bill pass hota hai medi assist

[@sayantanisdiary6254]

If it is a valid bill, 100% will be reimbursed. Also depends on your policy and eligibility.

[@shabbarhassan2787]

N for housewife? How the husband claim/reimburse max benefits u plzzz explain?

[@biswa012]

If she is housewife but purchased a separate policy then you can claim same way I have explained. However, if your wife is a nominee of your policy only then only one claim is possible. Please be mindful here we are talking about claiming using multiple policies for same hospitalization and not by claiming by multiple person for same treatment under one policy.

[@deivanaipl5157]

Can we claim monthly scan bills ?

[@biswa012]

If it falls within pre hospitalisation period of your policy

[@automationchat9853]

Thank You Bro

[@sukanyamodak6245]

We are having two seperate insurance one is cashless which my husband is going to take care of and another is reimbursement which i am going to claim.in case of pre hospitalisation test or medicine if my husband has paid the bill with his credit card,can i submit that bill in my insurance reimbursement claim?

[@biswa012]

Payer doesn't matter. Test report and all bills should reflect your name and prefer buying medicine online and it should be billed to your name as customer.

[@biswa012]

Actually in both the claims insured beneficiary is you. So if all the bills and reports reflect your name both of your claims are valid irrespective of who is paying.

[@KhuviJais]

Do we claim for miscarriage?

[@sayantanisdiary6254]

I think yes. Please confirm with TPO

[@MaheshPuli-g2o]

Hi

[@My-Aadhya-world]

Hi Sir , Me and my wife, both working different companies with same TPA(Medi Assist/Medibuddy).The insurance provider is same for both. its new india assurance.My wife total maternity bill is 50k. I already applied, and the provider settelled the 48k. Should I re-use the same bills and apply a new claim for my wife's medi-assistance account? it is legal or not? Thank you

[@My-Aadhya-world]

Please suggest

[@biswa012]

It depends. If total bill is 50K and 48K already settled and unsettled amount is due to consumable expenses like ppe kit, bandage etc then in second claim also those will not be accounted. This video is for the cases where total bill is more than claim limit in that case we can use second policy to claim the excess amount. This is illegal to make duplicate claim using 2 policies. In your case you shouldn't.

[@sanjusanju8905]

Can you please mention how to claim maternity bills....

[@urmilasingh5429]

Hello sir

[@satishjha741]

Worse company mediassist