Procedure for making claims in CGHS

1. In the normal course, prior authorisation from the CGHS Doctors is required.
2. In case of emergency, the CGHS beneficiary may directly go to the recognised Hospitals for treatment. However an emergency cerificate should be obtained from the treating Doctor.
3. In the normal course, the claim should be made in three months. However delay condonation will be made if valid reasons are stated.
4. Claims/reimbursements are allowed only for inpatient period.
5. Each inpatient period claim should be submitted separately.
6. The claim should be by the main card holder only even in case of dependants. If the main card holder is unable to put his/her signature, thumb impression may be made with the certificate of the treating Doctor duly stating the inability to sign.
7. In  case of the demise of the main card holder,  the spouse must apply and get the family pensioner card.
8. The claim should be in two sets (one original and another xerox set). The papers in the claim should be tagged in the following order:
(1). Requisition to Associate Director CGHS Bangalore.
(2). Medical reimbursement claim form