Medi Assist India — Claim Repudiated - Even after provided all necessary documents

Saravana Kumar Punyam

Feb 26, 2025

Address: Tower D, 4th Floor, IBC Knowledge Park, 4/1 Bannerghatta Road, Bangalore - 560 029

Website: mediassisttpa.in

Dear Team,

I am registered with MEDI ASSIST past many years. Under the Corporate policy, My mother also added along with me.

Claim No :[protected]
Policy: Gold
Patient Name : P INDRANI
MAID : [protected]
Hospital : Sudharsan Hospital
Treatment Date : 22-Jan[protected]Jan-2025
Ailment Summary : Infectious Disease
Claimed Amount : Rs. 39, 588/-

As per policy, I have uploaded all documents in the system in the system for reimbursement claim.

initially, Separate Payment receipt was not provided by the hospital.

Instead of providing payment receipt. They are providing Hospital seal with Authorized signature on top of Final billing as paid. In the Final Bill itself have the Bill number for Payment receipt and Final Bill Number of IPD number also available. The same information I have given to the mediassist team when i receive the first reminder for missing documents. Team suggest to provide clarification letter from hospital for non-available documents. I have collected the clarification letter from hospital and same has been uploaded in the system. After Two reminders of same query, claim status went to Repudiated-Awaiting for Insurance concurrence. Now, claim got repudiated with reason of missing documents i.e., payment receipt.

After discussing with the hospital, I have received the separate payment receipt for the Final bill. But again mentioning that On top of Final Bill and Payment receipt number is same because it Bill number is created referred w.r.to the final bill.

I have contacted the medi assist support team thru call, team suggest to provide the clarification letter for non-available documents received from the hospital. I have provided the same clarification letter in the system. But, Team which contacting thru the mail, they are not accepting the clarification letter

Attached Final Bill, Clarification for reference

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Medi Assist India customer support has been notified about the posted complaint.

Feb 26, 2025

Updated by Saravana Kumar Punyam As per policy, I have uploaded all documents in the system for reimbursement claim.

Initially, Separate Payment receipt was not provided by the hospital.

Instead of providing separate payment receipt. They are providing Hospital seal with Authorized signature on top of Final billing as paid. In the Final Bill itself have the Bill number for Payment receipt and IPD number for Admission also available. The same information I have given to the mediassist team when i receive the first reminder for missing documents. Team suggest to provide clarification letter from hospital for non-available documents. I have collected the clarification letter from hospital and same has been uploaded in the system. After Two reminders of same query, claim status went to Repudiated-Awaiting for Insurance concurrence. After that it went to repudiated with reason of missing documents i.e., payment receipt.

After discussing with the hospital, I have Collected the separate payment receipt for the Final bill. But, in the receipt consists same Bill number referred with Final Bill. But mediassit team not considering the receipt and ststing that Final Bill number and receipt number should not be same. Hospital team justifying that Bill numbere provided on behalf of Final Bill. If new Bill number is required then they are asking to pay again the Final amount. The same information i have provided to the mediassit via call and mail. In call, they mentioned that they are accepted and escalated internally. But in mail conversation again they are same question that Payment receipt is not available and provided payment receipt consists the same bill number as Final bill

I have contacted the medi assist support team thru call, team suggest to provide the clarification letter for non-available documents received from the hospital. I have provided the same clarification letter in the system. But, Team which contacting thru the mail, they are not accepting the clarification letter

Attached Final Bill, Clarification for reference