A query round costs a fortnight and a person. Most of them ask for something that existed at discharge and was not attached.
The standard set
| Item | Establishes | Obtainable later? |
|---|---|---|
| Claim form, signed | The claim itself | Yes |
| Policy and ID verification | Who is covered | Yes |
| Pre-authorisation and enhancements | What was approved, and when | Yes |
| Discharge summary | Necessity, course, duration | Yes, but rewriting invites scrutiny |
| Investigation reports | Clinical basis for the treatment | Usually |
| Itemised final bill | What is being claimed | Yes |
| Implant invoice, lot or serial | That the device was used on this patient | Often not — supplier records lag |
| Consent, clinical and financial | Authorisation and accepted cost | No — requires the patient |
| Medico-legal intimation where required | Statutory compliance | No — the window has passed |
The last three rows are the whole point
Everything above them can be retrieved from a system afterwards. Consent needs a person who has gone home; medico-legal intimation has a statutory window; implant documentation depends on a supplier who has moved on. These are the items that turn a query into a write-off.
Freeze the file, then submit
A completeness check at discharge, blocking on the three irrecoverable rows, costs minutes and removes the majority of query rounds. Submitting fast and completing later feels quicker and is the reason claims sit unsettled for two months.
Questions we get asked
What documents should a cashless claim file contain?
The signed claim form, policy and identity verification, the pre-authorisation and any enhancements, the discharge summary, investigation reports, an itemised final bill, implant invoices with lot or serial numbers where devices were used, both clinical and financial consent, and medico-legal intimation where the case required it.
Which claim documents cannot be obtained after discharge?
Consent, because it requires the patient to be present; medico-legal intimation, because it has a statutory window that has passed; and often implant documentation, because supplier records lag and the specific invoice becomes hard to tie to the case. These three are what turn a query into a write-off.
On the figures in this piece. Every rupee amount above is arithmetic on the assumptions stated beside it, not a market statistic. Where you need published Indian claim data with its source named, that sits on claim data. We publish no figure we cannot show the working for.