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How to Claim Outpatient and Inpatient Health Insurance

How to Claim Outpatient and Inpatient Health Insurance

One type of insurance that is widely used by people is health insurance. Health insurance aims to provide protection or protection to the insured when he is sick. So, if you are sick and want to use insurance as payment, then you have to make a claim first. How to claim health insurance is also very easy to do.

Health insurance claims are generally divided into two types, namely outpatient and inpatient. The two types have quite different claim procedures. Therefore, you need to know the procedure for claiming health insurance for each of these types. Here is the complete information that you can see!

How to Claim Outpatient Health Insurance

If you are sick but want outpatient treatment, then you must do the following.

Filling in form

To make an outpatient health insurance claim, the first thing to do is fill out a form. Make sure you fill out the claim form with the correct data.

Completing Documents

After filling out the form, then you must complete the required documents. The claim documents, which include:

        Proof of maintenance payment and original receipt

        Details of the original doctor's treatment

        Reports or medical records from the original doctor

        Cost of drugs and services provided to the insured

Submitting a Claim to the Insurance Party

If all documents are complete, then you can submit a claim to the insurance company. File a claim as soon as possible because there is usually an expiration date.

How to Claim Inpatient Health Insurance

After knowing the insurance claim procedure for outpatients, now is the time to know the inpatient insurance claim procedure. To make an inpatient health insurance claim, the following are the ways that must be done.

Meet Claim Requirements

The first thing that must be done is to fulfill each item of the requirements for submitting a claim. You can see various requirements for insurance claims in an insurance policy. You must ensure that the policy is not in a grace period. In addition, you must also ensure that the claim is submitted when the premium is active and the premium installments have been paid off.

Contacting Insurance Company

After making sure all the requirements are complete, the next thing to do is contact the insurance company. Usually, you must contact the insurance company before hospitalization. However, in the event of an emergency, you must contact the insurance company no later than 2x24 hours after hospitalization.

Include Supporting Documents

When submitting the requirements file to the insurance company, you must also include the various supporting documents needed. The supporting documents include personal identity, policy number, name of the intended doctor, doctor's referral letter, name of the hospital, and the insured's medical condition.

Choosing a Hospital

After the insurer accepts the inpatient claim submission, you will then be given information regarding the hospital reference that the insurance company partners with. Therefore, you can do hospitalization at an insurance company partner hospital in order to get benefits in the form of not having to pay upfront treatment costs.


After you choose and arrive at the insurance partner's hospital, then you must show your policy identity or insurance card. In addition, you also have to submit various necessary administrative files to the hospital.


This is information about how to claim outpatient and inpatient health insurance that must be known by the owner of health insurance products. By submitting an insurance claim, you can be helped financially to deal with unstable financial conditions due to medical and care costs. This is one of the advantages of having health insurance that you can get.



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