Precautions & Procedure of Claiming Medical Reimbursement Charges

Medical Reimbursement Charges is the amount that is claimed by the Govt Employee due to the illness or disease of his family, parents or himself. Although the process of claiming Medical Charges is somewhat difficult, however if the following rulings be kept in mind then this process can be made easy.

  1. “Typed Application” of the claimant regarding reimbursement of medical charges showing name of hospital, disease & patient with relationship be attached with the case.
  2. Medical proforma must be signed by the employee & the concerned authorities & countersigned by Civil Surgeon/Medical Superintendent (with name stamp).
  3. Dependent certificate clearly showing age and relationship duly verified by the Controlling Officer must be attached with the claim.
  4. In case of reimbursement of expenditure incurred on treatment of parents (Father/Mother) of the Govt Employee, certificate regarding “Wholly Dependent  upon the Govt Employee duly signed by the employee and the Head of the institution be attached.
  5. Name and quantity of medicine should be clearly shown on the prescription slip.
  6. Cash memo No., date, name of chemist, quantity and cost of medicines shown in cash memos/vouchers are clearly shown on medical claim proforma.
  7. Cash memos issued by the chemist/medical stores must be on proper printed form with printed license No. of the chemist and duly signed/stamped by the authorized medical attendant.
  8.           Cost of the medicines shown in cash memos/vouchers should be correctly entered in the medical claim proforma.
  9. History treatment card of the patient on printed form of the hospital be attached.
  10. Original Prescription Slip/Certificate duly written on the printed pad of the hospital concerned bearing O.P.D No., Name, Age, Sex and disease/diagnoses of the patient duly signed/stamped by the treating doctor and original admission/discharge certificate (in case of indoor treatment) duly signed/countersigned by the treating doctor & Civil Surgeon/Medical Superintendent respectively be attached.
  11. In case the patient is referred to some other hospital by the authorized Medical Attendant of such referral letter/move sanction, as case may be, be attached with the claim.
  12. If any patient is got treatment from any unauthorized/private hospital/clinic in emergency, an “Emergency Certificate” on printed pad of the treating doctor showing nature of disease and treatment given, duly signed/countersigned by the treating doctor (with by name stamp) & Medical Superintendent /Civil Surgeon (with by name stamp) will be attached with the claim.
  13. If any patient is got treatment from any unauthorized/private hospital/clinic in emergency, “Distance Certificate” clearly showing the distance from the residence to authorized and unauthorized hospital duly signed/countersigned by the Govt Servant & Head of the Institution be finished.
  14. The claims of Medical Reimbursement are only allowed in case of Accident or Extreme Emergency.
  15. In case of medical reimbursement expenditures occurred on family members (wife, husband, children or parents) attested copy of CNIC or form ‘B’ issued by NADRA be attached with the claim.
  16. In case of medical re-imbursement expenditures occurred on spouse or children above 18 years of age their “Status Certificate” showing whether they are Govt Employee or otherwise may also be attached.
  17. Only one original copy of the case be submitted to the higher authorities the other copy be kept by the office of the employee.
  18. The case must be submitted to the higher authorities within the 60 days of discharge of patient.
  19. Cost of Unani. Ayurvedic and Homeopathic medicines cannot be included in the claim bill.
  20. Transportation charges of the patient are not to be included in the claim.
  21. Cost of laboratory tests taken from authorized/unauthorized hospital/laboratory is admissible on the basis of reference by the Authorized Medical Attendant only.
  22. Cost of vaccine (s), blood and products is allowed.
  23. The cost of the following items is not admissible:
  •           Cost of organs and tissues in case of transplant.
  •           Soaps and Detergents
  •           Food Supplements
  •           Toilet and Cosmetic Goods
  •           Thermometer
  •           Expenses incurred on medical treatment abroad

24.  The cost of the following items is reimbursable:

  •           Antiseptic Liquids as prescribed
  •           Disposables as prescribed

25. “Dental treatment” includes treatment of alveolar (gum and jaw bones) diseases, extraction of teeth, treatment for dental caries, gingivitis, pyorrhea and filling temporary or permanent) of dental cavities including root canal treatment, sealing, but does not include dental implants, orthodontic application, bridging, crowning and provision of dentures.

If you follow the above mentioned claims processing for medical reimbursement, you will have to face no difficulty.

 

Share this post

71 thoughts on “Precautions & Procedure of Claiming Medical Reimbursement Charges

  1. AoA Sir.
    My father is retired from Pakistan Railway as Skilled Fitter in BPS-09. He got admitted in CMH for Heart Treatment in emergency. He discharged from the hospital and died at home after 2 days.
    Sir, I am also a Federal government employee. Can i reimbursed the medical charges from my office incurred upon my father?

    Reply
  2. meray abu army se retired hain brain sol ki surgery hoi hai vp shunt buy kia hai Rs 50000 ka to kindly recovry kesay ho sakti hai ?

    Reply
  3. R/Sir/Madam,
    How can a govt employee claim the medical charges incurred on the treatment, of his family member patient with blood cancer, got from a private doctor.

    Reply
  4. dear sir, i want some question about medical reimbursement that a person got treatment from unauthorized/private hospital, could he claim the doctor’s fees, bed charges, anesthesia charges, room charges or not? plz explain briefly

    Reply
  5. Sir I want to ask that, can we claim for eye glasses for re-imbursement in medical claim, if yes in which account, or if no then how.
    Please guide me

    Reply
      1. Thanks Sir, but it would not help me till the provision of any legimate aurthority letter or policy letter. If could be possible for you to search and guide accordingly, I shall ever remain thankful to your kind.

        Reply
  6. Asalam o alikum
    M servant of govt of punjab education dept … I want my medical claim m patient of cancer under tha treatment of shaukat khanam lahore … plz send me notification for medical reimbursment …

    Ishtiaq ahmed Chaudhary o.o ceo education rawalpindi 03319429681

    Reply
  7. Assalam-o-alykum,

    My father is retired Associate Professor from Punjab Government. he is now had Kidney Failure issue. I got treatment from Shifa International Hospital and Dialysis is become now regular activity.
    I need to know, is there any Punjab government policy of medical bills reimbursement?

    Reply
  8. Assalam o Alaikum

    I have an issue, I cleared FPSC exam and inducted in FBR as Inspector Inland revenue

    They civil surgeon gave me provisional medical fittness certificate, but the director from ISLAMABAD (Mr Irfan Tahir) is not giving final certificate of fittness due to over weight problem they are following BMI)BODY MASS INDEX calculator, can any one please help me in getting final medical certifiacte as it is requirement for getting permenant on Job in FBR,

    I am tensed due to this.

    0332-3524909

    Reply
  9. Salam o Alaikum,
    My Son is Thalasseamia Major patient, being a prolonged disease what are the rules and regulations of claiming the out door treatment from govt hospitals.

    Reply
  10. salaam , maam , my father is a retired professor of grade 20 at a punjab govt college in rawalpindi, he retied in 1996. In 2012 he had placed 4 heart stents in his heart at military hospital rawalindi which did cost at 8 lac, At that time we did not know about reimbursement , can we now reimbursement of that 8 lac?

    Reply
  11. salaam,
    respected mam ,my father is a retired associate professor of grade 20 of gordon college ,rawalpindi,he retired in 1996 and in 2012 he had operation in military hospital rawalpindi and doctors placed four stunts in his heart which costs around 8 lac . at that time we did not know any reimbursement rulesand we did not consult any department at that time,now some one suggested us that we can refund this amount.kindly tell us whether we can refund that 8 lac ,if yes then which department or person we consult for reimbursement.thanks a lot.

    Reply
  12. Assalam o Alaikum, i want to know how many reimbursement claims can be claimed for delivery cases? i heard that only one delivery case is could be claimed.

    Reply
  13. my father was retired from govt in BPS-20 and he expired due to heart attack and when he was operated in private hospital in islamabad, there were some expenses like 5 lac, and i submitted bill to the organization of my father, they denied that the bill is of non panel hospital, i carried him because of emergency and islamabad was more easy than karachi from bahawalpur. can i apply again or not

    Reply
  14. Dear Mam,
    My farher has passed away and he was govt servant in customs and centeral excise. My mother is getting cancer treatment in a private hospital. Is there any way if we can get reimbursement beimg widow since its a private hospital?
    Regards.

    Reply
  15. AOA. I m federal government employee. My medical reimbursement bills are verified by MS Holy Family Hospital but the deaprtment says that Civil Surgeons verification is necessary for reimbursement. Do I need to verify these by civil surgeon who sits in Benazir Bhutto Hospital and either he is liable to verify these bills? Any guidance or reference plz. My email [email protected]

    Reply
  16. Assalam o Alaikum Respected Miss Shumaila Kamal,I am DDO of my Department in Provincial setup. One of our Field Office Stenographer has got done his wife delivery operation from CMH MULTAN. Is his bill reimbursable from Provicial Government. Please provide relevant notification or rules. My email ID is [email protected]. The Best Regards. Arif Aziz

    Reply
  17. AoA
    The wife of the Punjab Govt. Officer (BS-16) was ill and went to Tehsil Headquarter Hospital, Chunian. The Authorized Medical Attendant, THQ, Chunian referred the patient to the ANMOL Hospital, Lahore being a Cancer case. The treatment of the patient was completed at ANMOL Hospital, Lahore and an expenditure of more than Rs. 0.200 million was incurred.
    Please guide us whether the Punjab Govt. Officer can claim the reimbursement of Rs. 0.200 million, whereas the ANMOL Hospital, Lahore is a Central Govt./Atomic Energy Commission Hospital. If yes, please provide any Punjab Govt. Notification/Rule etc.

    Reply
  18. Kindly provide me the following letters readable copies regarding reimbursement of medical charges

    No.FD.PC-2-2/2010 dated 15-7-2010

    No.FDSR-1-1-78/2010 dated 3-12-2012

    thankx

    Reply
  19. Respectfully, You are doing great work.
    I need medical charges reimbursement policy of Govt of Punjab. My wife underwent Cesarian operation in hospital for baby birth. Kindly support with concerned documents.
    Regards.

    Reply
  20. The case must be submitted to the higher authorities within the 60 days of discharge of patient.
    have you any ruling / notification regarding the above matter?

    plz. guide

    thanks & regards

    attnn: ShumailaKamal

    Reply
  21. Nadeem Ahmad Awan · Edit

    Mam!
    The federal govt. officers from B-16 to 22 are entitled to re-reimbursement of expenses incurred on diagnostic investigation and consultation at OPDs. Whether the employees from B-1 to 15 are also entitled for this facility or otherwise?

    Plz clarify with relevant Notification/O.M. No.

    Reply
  22. aoa.

    plz tell me whether there is any upper ceiling (financial ceiling) of indoor medical treatment claim in any provincial or federal department or armed forces?

    Reply
  23. Hi
    i am in grade 17. i am patient of ankyloosing spindilitis. dr.’s saying that i need injections weekly for 6 month. (Cost 6,000000)
    dear there is any way that govt compensate me before treatment. i now that medical claim will be due after treatment. but i have not enough money at the moment. pls reply soon

    Reply
  24. i want to know how is sanction authority of medical reimbursement cases of retired persons in district governments while no any department have budget for pensioners?

    Reply
  25. I need to know that whether a contract employee can also claim the medical reimbursement especially for a By Pass Operation (Cardiac Surgery)? Please reply early as the patient is going to be operated on 15th of this Month….

    Thanks.

    Reply
    1. Dear Raza, not confirm. I think it is for all employees. If an Contract employee can get Medical Allowance then why he cannot claim medical re-Imbursment?

      Reply
  26. i am ali in grade 16 employee of Pakistan audit department. i am pleased to clarify that in case of emergency, in private hospital, is anesthesia fee, ICU operative charges and theater charges is admissible for reimbursement or not please guide me with the reference of rule if admissible or vice versa,

    Reply
  27. I am in grade 16 employee and enjoying the facility of medical allowance Rs. 1000/- per month. Whether I submit the medical claim or not , pleae reply.

    Reply
      1. dear shumaila kamal shiba, District Government main 50000 to above to 01 lac DCO Sb authority hain Medical reimbursement main only powers delegated hain retired/in service and contract etc shamil hain. thanks

        Reply

Post Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.