(1) Final claims for reimbursement of medical expenses for a particular spell of illness shall ordinarily be preferred within three months from the date of completion of the treatments shown in the prescription issued by the attending physician.
(2) All claims for reimbursement shall be accompanied with prescription and cash memos or vouchers duly signed by the Medical Officer indicating the registration number.
(3) The application for medical claims shall be submitted in the Form given at Appendix A.
(4) All expenses on indoor treatment shall initially be met by the employee himself and shall claim for medical reimbursement on completion of the treatment.
(5) Normally the recognised private hospitals or diagnostic centres, who entered into agreement with the Appellate Tribunal, shall charge the rates approved for the package rate and they shall also extend credit facility in emergency cases as specified in the Memorandum of Agreement signed with private hospitals or diagnostic centres to the employees of the Appellate Tribunal undertaking treatment in their hospital or diagnostic centre, and submit the bill for reimbursement as per approved rates to the Appellate Tribunal:
Provided that in case of hospital or diagnostics centres insisting for immediate payment of the cost of treatment, room rent, medicines, various test, etc., the Appellate Tribunal may sanction advance payment to the extent of ninety per cent. of approximate expenses as per package rate prescribed for Central Government Health Scheme beneficiaries and issue an account payee cheque in the name of the hospital concerned, and the balance payment shall be made on submission of final claim by the beneficiary.
OUTDOOR TREATMENT