Claims and Reimbursements Sample Clauses

Claims and Reimbursements. 1. REIMBURSEMENTPROCEDURE All claims for reimbursement must be submitted or forwarded to MediCard Head Office within thirty (30) calendar days after discharge from the hospital. Failure to do so shall invalidate the claim, except if it can be shown in writing that it was not reasonably possible to furnish such documents within thirty (30) calendar days. Required documents in availing reimbursement: a. Emergency confinement in non-accredited hospital attended by a non-accredited doctor  Duly filled-up claim form  Clinical Abstract  Medical Certificate to include complete final diagnosis  Surgical/Operative report if an operation was done  Original Official Receipt paid to hospital and doctor  Hospital statement of account and corresponding charge slips  Police report if due to accidentor medico-legal case  Incident report why MEMBER was confined in a non-accredited hospital b. Emergency confinement in an accredited hospital attended to by a non-accredited doctor  Duly filled-up claim form  Clinical Abstract  Medical Certificate to include complete final diagnosis  Original Official Receipt paid to the hospital and doctor  Hospital statement of account and corresponding charge slips  Police report if due to accidentor medico-legal case  Incident report or proof that MediCard accredited doctor was not available during the time of confinement c. Out-Patient emergency consultation/treatment by a non-accredited doctor in areas where there are accredited hospitals/clinics.  Medical Certificate to include complete final diagnosis  Original Official Receipt paid to the doctor  Incident report  Police report if due to accidentor medico-legal case d. Out-Patient emergency or non-emergency consultation/treatment by a non- accredited doctor in areas where there is no accredited Hospital/Clinic.  Medical Certificate to include complete final diagnosis  Original Official Receipt  Incident report  Police report if due to accidentor medico-legal case

Claims and Reimbursements. The SFA will claim meals at the “free” rates prescribed by USDA for the NSLP (including snacks) and SBP. Supper meals, if permitted by the state agency under the amendment will be claimed at the free rate for NSLP lunches. A claim will be submitted reflecting these option meals during the summer months. All lunches and suppers will receive the standard commodity support rate available for the NSLP. Option sites that qualify for the severe need breakfast rate will continue to receive this rate for reimbursement.

Claims and Reimbursements