ONLINE CLAIM

SUBMISSION PROCESS
 ONLINE CLAIM SUBMISSION
TO BE DONE IN

3
WAYS

Vidal Health App

Employee Portal

Online process i.e. via email

“Self declaration form”

is mandatory while
submitting online claim forms
VIDAL HEALTH
APP
 HEALTH CLAIMS

Customers to download the “Vidal Health App” from the play store/Apps
store for Android/iOS applications.

Customers to login to the application using the registered mobile and

email address.

To submit an online claim, policyholders to click on “Health Claims” as

shown in Figure 1: Health Claims

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Note:
If the registered users have logged in through the registered mobile number, user can easily access
Health Claims section without logging in again.
If the policy holder has not logged in through the registered mobile, then he/she has to login through
the Vidal Health (Username or password) credentials to access Health Claims module.
 POLICY SELECTION

• User has to select the policy.

• The base policy shall be displayed by default, in case there are multiple
policies available under the same user, the user can select the desired policy
by toggling between the policy numbers.

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 REIMBURSE

• User has to click on Reimburse

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 REIMBURSE

• Clcik on Add Button (+) as shown in below

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 PATIENT PARTICULARS

• Clicking on the Add button (+) the user screen will display the following fields:
A) Patient Particulars:
• Clicking on <Patient Particulars> there will be two fields with a dropdown
allowing the user to select the desired with hint text<Patient name>,
• Clicking on the <Patient Name> a dropdown pops up with the entire
patient name list, user can select one of the names and automatically the
Enrollment ID is fetched according to the patient name.
• The<Next> button is enabled if all the two fields are entered. Clicking on
the Next button will move the user to the below fields.

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 HOSPITAL DETAILS

B) Hospital Details:
• As the user clicks on the Hospitals details a dropdown opens will follow-
follow
ing fields to enter details.
• Hospital Name(Hint Text): As the user has to enter hospital name
• State: Pre filled based on the Geo Location
• City: Pre filled based on the Geo Location.
• <Reset>: Clicking on the reset button will refresh the screen and
the entered details will get deleted, user has to fill data gain.
• The <Next> button is enabled if all the fields are entered. Clicking
on the <Next> button will move the user to the below fields.

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 HOSPITALIZATION DETAILS

C) Hospitalization Details:
• Policyholders will have to input following fields:
o Date of Admission: User can select date all from the calendar
popped out on the screen.
o Time of Admission: User can select date all from the calendar
popped out on the screen.
Date of Discharge: User can select date of discharge from the
calendar popped out on screen.
o Time of Discharge: User can select date of discharge from the
calendar popped out on screen.

o Physician’s Name: User has to enter a

8:30 Physician’s Name
o Physician’s Phone: User has to enter a
Physician’s number.
o Requested Amount: User has to enter
Total claim amount.
o Aliment Name: User has to enter the
Aliment
o <Reset>: Clicking on the reset button
will refresh the screen and the entered
details will get deleted, user has to
enter data again.
o The <Next> button is enabled if all the
fields are entered. Clicking on the
<Next> button will move the user to
the below fields.
 ACCOUNT DETAILS

D) Account Details:
• User has to enter all the account details to get the reimbursement/claim
amount.
o Account Holder Name
o IFSC/RTCG Code
o Bank Name
o Branch MICR
o Account No.
o Branch Address

o Remark
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o <Reset>: Clicking on the reset button
will refresh the screen and the entered
details will get deleted, user has to
enter data again.
o The <Next> button is enabled if all the
fields are entered. Clicking on the
<Next> button will move the user to
the below fields.
 UPLOAD DOCUMENTS

E) Upload Documents:
• User can upload the claim documents through <Upload Documents> option.
o Document Type: Clicking on this option will display a popup with all
type documents. Example (Lab reports/ CT scan/ Bills etc.) wants to
claim, user has to select from these document list or can search the
document type.
o Amount: User has to enter exact amount in numerical value which
the user wants to claim.
o Claim Type: Clicking in the claim type will display a popup screen
with claim type Example: (Main Claim/Pre Hospitalization/Post
Hospitalization) selecting any one will fill the data on the claim type
field.
o Upload Document: User can submit claim documents through this
button through following ways.
o Claim documents can be uploaded through various format: (PDF
8MB max, JPEG, JPG files)
> Take photo: User can take a photo of their claim documents
and upload.
> Upload Photo: User can upload a claim document in JPEG or
JPG format if already available in the photo gallery.
> Upload Document: User can select this option to upload JPEG,
JPG or PDF format by browsing the folders available in the user
mobile. Device.
> Add button: Clicking on the add button a user pre-filled data in
a popup get displayed with following fields below.
» Document Type:
» Amount:
» Claim Type:
» Camera Upload:
> Reset Button: Clicking on the <reset> button will refresh the
screen and the entered details will get deleted, user has to
enter data again.
> Submit Button: Click on the <submit> button which will give
confirmation message on the screen.
 UPLOAD DOCUMENTS

Note: After uploading softcopies of Insurance holder must send hard copies to the
Vidal Health for getting approval of their claims amount.

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EMPLOYEE PORTAL
 CLAIMS

• Employee portal is accessible only for corporate employees.

• Corporate employees will have to login to

https://tips.vidalhealthtpa.com/vidalhealth/ with their credentials.

Self declaration form is mandatory while submitting the claims Online

Step 1: Click on Claims --> Reimbursements

Step 2: Select the respective policy displayed on left side as shown in below screen.
 CLAIM SUBMISSIONS

Step 3: Navigate on “CLAIM SUBMISSIONS” tab and click on “Submit Claims” button for
submitting online claim.

Step 4: Fill in the below mandatory fields and click on “Submit” button
A. Under “Claim details”, fill in below fields mandatory fields:
o Vidal Health Insurance TPA ID / Name
o Ailments
o Admission date
o Discharge Date

B. Under “Hospital information, fill in below mandatory field:

o Hospital Name

C. Under “Upload Documents”, Upload required documents

Note: Figure on next page

CLAIM SUBMISSIONS
 CLAIM SUBMISSIONS

Step 5: The submitted claims will appear under “CLAIM SUBMISSION” tab.
• Users to click on generate icon to download the prepopulated Claim form
• Click on submit icon to upload the self attested claim form along with the self declaration
form (Download prepopulated form)
ONLINE PROCESS
VIA EMAIL
 ONLINE PROCESS VIA EMAIL

• If the claimants/providers are unable to submit the claims through Vidal health
app or through employee portal, they can submit the claims through email
with attachments.
• Claimants/providers to submit claims with attachments on this below provided
email address: claimsdocuments@vidalhealthtpa.com

Note: Customers will also have to submit self declaration form on mandatory basis