TeleMedhin

How to File anInsurance Claim

Simple, fast claim processing with an average turnaround of 7 days. Submit claims online and track them in real-time.

The Claims Process

Five simple steps from treatment to payment.

1

Get Treatment

Visit any TeleMedhin network provider and receive the medical care you need.

  • Show your insurance card at registration
  • Provider verifies your coverage
  • Receive treatment from qualified professionals
  • Keep all medical receipts and reports
2

Gather Documents

Collect all necessary documents and receipts from your medical visit.

  • Original medical receipts
  • Doctor's report or discharge summary
  • Lab test results (if applicable)
  • Prescription and pharmacy receipts
3

Submit Claim

Upload your claim documents through our online portal or mobile app.

  • Log into your member portal
  • Fill out the claim form
  • Upload clear photos/scans of documents
  • Submit for processing
4

Claim Review

Our team reviews your claim and verifies coverage and documentation.

  • Automated eligibility check
  • Document verification
  • Coverage confirmation
  • Email updates on progress
5

Get Paid

Approved claims are paid directly to your bank account or mobile wallet.

  • Average processing: 7 business days
  • Direct deposit to your account
  • SMS and email confirmation
  • Digital receipt for your records

Required Documents by Claim Type

What you need to submit for different types of claims.

Hospitalization Claims

  • Hospital admission and discharge papers
  • Original hospital bills and receipts
  • Doctor's reports and prescriptions
  • Lab test and imaging results
  • Copy of your insurance card

Outpatient Claims

  • Doctor's consultation receipt
  • Medical prescription
  • Pharmacy receipts
  • Lab test receipts and results
  • Copy of your insurance card

Maternity Claims

  • Hospital delivery receipts
  • Antenatal and postnatal care receipts
  • Doctor's reports
  • Birth certificate (for newborn coverage)
  • Copy of your insurance card

Disability Claims

  • Medical assessment report
  • Doctor's disability certification
  • Hospital treatment records
  • Ongoing treatment receipts
  • Copy of your insurance card

Tips for Faster Claims

Follow these tips to ensure quick and smooth claim processing.

Submit Claims Promptly

File your claim within 30 days of treatment for faster processing.

Keep Original Documents

Always keep originals until your claim is fully processed and paid.

Clear Photos

Take clear, well-lit photos of all documents. Ensure text is readable.

Track Your Claim

Use our portal or app to track claim status in real-time.

Contact Support

Reach out if you need help or have questions about your claim.

Update Information

Ensure your bank details and contact info are current in your profile.

Claims FAQs

Common questions about filing and tracking claims.

How long does claim processing take?

Most claims are processed within 7 business days. Complex cases may take up to 14 days. You'll receive updates via SMS and email.

Can I submit claims for out-of-network providers?

Yes, but reimbursement rates may be lower. We recommend using network providers for maximum coverage and faster processing.

What if my claim is denied?

You'll receive a detailed explanation. You can appeal the decision within 30 days by providing additional documentation or clarification.

How do I track my claim status?

Log into your member portal or mobile app to view real-time claim status. You'll also receive SMS/email updates at each stage.

Can I submit claims via WhatsApp?

Not yet, but we're working on it! Currently, you can submit claims through our website, mobile app, email, or by visiting our office.

Do I need to pay upfront?

At network providers, you may only pay your co-payment. For out-of-network care, you may need to pay upfront and get reimbursed.

Need Help with Your Claim?

Our claims support team is here to assist you 24/7.