PDF Member Reimbursement Form - Health First 2025

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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What Is Reimbursement Claim in Health Insurance? Reimbursement claims are insurance claims wherein you pay for your hospital bills after your treatment and then submit the relevant documents to your insurance provider for a pay out as per the policy coverage.
Simply call 800-226-5116 Monday through Friday from 8 a.m. to 8 p.m. (Eastern Standard Time) and identify yourself as a health plan participant accessing First Health Network.
When a claim arises you should inform the insurance company as per procedures required. After hospitalisation, you have to ensure that you obtain and keep ready documents such as claim form, discharge summary, prescriptions and bills that you should submit for a claim.
How do I submit a claim for processing? In most cases, your provider will file the claim directly for you. If you are filing your own claims, you must submit an itemized statement to the claims mailing address indicated on your ID card. We recommend including receipts with your claims.
At times, you may be required to submit a claim form and your receipts for reimbursement for prescriptions filled at a retail pharmacy. This process of reimbursing is called Direct Member Reimbursement, or DMR.

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Here are the steps that you need to follow to file a reimbursement mediclaim insurance claim: Step 1: Inform the Insurance Company. Step 2: Obtain Treatment. Step 3: Pay the Hospital Bill. Step 4: Collect All Your Documents. Step 5: Fill up the Claim Form. Step 6: Submit All the Documents to the Insurance Provider.
If you suspect a case of fraud, waste, abuse, or other violations of company policy, you can report it by: Calling our toll-free Confidential Compliance Hotline: 1-877-879-9137.

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