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  • Nhif Outpatient Submission Form-18b

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    maoaweys hospital
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    The document is a submission of outpatient claims from a hospital to the National Hospital Insurance Fund. It includes a header with the hospital's address and code number. A statement of account for a particular week-ending date is enclosed, along with claim forms providing patient names, member numbers, dates of treatment, invoice numbers, claimed amounts, and remarks. The total claimed amount for reimbursement to the hospital is also listed.

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    The document is a submission of outpatient claims from a hospital to the National Hospital Insurance Fund. It includes a header with the hospital's address and code number. A statement of account for a particular week-ending date is enclosed, along with claim forms providing patient names, member numbers, dates of treatment, invoice numbers, claimed amounts, and remarks. The total claimed amount for reimbursement to the hospital is also listed.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    295 views2 pages

    Nhif Outpatient Submission Form-18b

    Uploaded by

    maoaweys hospital
    The document is a submission of outpatient claims from a hospital to the National Hospital Insurance Fund. It includes a header with the hospital's address and code number. A statement of account for a particular week-ending date is enclosed, along with claim forms providing patient names, member numbers, dates of treatment, invoice numbers, claimed amounts, and remarks. The total claimed amount for reimbursement to the hospital is also listed.

    Copyright:

    © All Rights Reserved
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    P.O.BOX 30443-00100,NAIROBI N.H.I.F.18B STAMP…………………………..

    SUBMISSION OF OUTTPATIENT CLAIMS

    DATE: ……………………………………………………………………………….

    NAME OF HOSPITAL: ………………………………………………………..

    CODE NO: ………………………………………………………………………..

    STATEMENT OF ACCOUNT OF WEEK-ENDING: ………………………………………………………………………

    Enclosed herewith are claim forms as detailed below to the value of Ksh…………………………...being benefits allowed to members.
    Please arrange to reimburse this hospital at your earliest.

    CLAIM NAME OF PATIENT MEMBER NO: DATE OF INVOICE CLAIMED REMARKS


    NO: TREATMENT NO: AMOUNT

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