Mednet Claim Process

MedNet is a third-party administrator (TPA) in the UAE, which plays an important role in the healthcare insurance industry. 

Before proceeding, it's important to understand what a TPA is. 

A TPA bridges the gap between healthcare providers, insurance companies, and customers. With numerous hospitals and customers, it can be challenging for you, as a customer, to identify which hospitals specialise in specific treatments and what their rates are. 

This is where TPAs come in. 

MedNet collects and manages data from various hospitals. This data is shared with insurance companies that use it to formulate healthcare plans. Whenever you purchase insurance plans and need to make a MedNet claim, your insurance company will generally direct you to their TPA. 

If your TPA is MedNet, they will have the required data to process your claim efficiently.

Some of the key services provided by MedNet include — 

1. Network Management: MedNet manages a comprehensive network of healthcare providers. 
2. Claims Processing: MedNet handles your insurance claims efficiently. It saves you from the stress of managing paperwork and also provides prompt settlements.
3. Customer Support: MedNet offers dedicated customer support to help you navigate your healthcare needs and insurance queries.

Types of Forms Available on the MedNet Website

MedNet offers several forms to facilitate different aspects of healthcare management for its members. Each form serves a specific purpose and is required under various circumstances. 

1. SOAP Form
   • Purpose: Used by MedNet's network providers to document patient interactions comprehensively
   • Required When: This form is needed for documenting subjective, objective, assessment, and plan (SOAP) notes during patient visits. It includes details such as member information, diagnostic procedures, treatment plans, and physician’s notes​.
2. MedNet Reimbursement Form
   • Purpose: To file for reimbursement of medical expenses incurred on a cash payment basis
   • Required When: Members need this form when they have paid for treatments out-of-pocket and seek reimbursement according to their insurance policy. It includes sections for detailing the treatment received, costs, and required documentation such as receipts and medical reports​.
3. Dubaicare-MedNet Reimbursement Form
   • Purpose: Designed for members under the Dubaicare collaboration with MedNet to claim reimbursements
   • Required When: Similar to the MedNet Reimbursement Form, this form is used when Dubaicare members pay for treatments upfront and need to claim back the expenses​.

How to Apply for a MedNet Reimbursement Claim Submission?

MedNet has streamlined the reimbursement claim process. You can submit and track your claims online efficiently.

To submit a MedNet claim, follow the given steps — 

Visit the Official Website

Go to the MedNet UAE website — mednet.ae.

Go to the Insured Members Tab

• Click on the ‘Insured Members’ tab
• Select ‘Claim Reimbursement’

Access the Reimbursement Claim Submission Page

• Click on ‘Submit a New Claim’

• You will be directed to a page where you can log in using one of three options: MedNet card number, Emirates ID, or DHA card number.
• Provide your date of birth and the treatment date to complete the login process.

Fill Out the Reimbursement Claim Form

Download and fill out the reimbursement claim form available on the website.

Make sure you have all the required documents, including —

• A detailed medical report with diagnosis and treatment plan from the treating doctor
• Original itemised receipts showing the cost per service
• Copies of diagnostic test results
• A referral letter from the treating physician if physiotherapy was prescribed
• A valid prescription for any prescribed medications
• A discharge summary or operative notes if you were hospitalised or had surgery
• A police report if the claim is related to an accident

Submit Your Claim

Once you have completed the form and gathered all necessary documents, submit your claim through the MedNet website.

Track Your Claim

• Use the Unique Claim Reference Number (UCRN) provided after submission to track the status of your claim online.
• You can monitor the progress from submission to settlement.

What are the Components of the MedNet Reimbursement Form? 

When filling out the MedNet reimbursement form, you need to provide various details to process your claim smoothly. 

The MedNet claim form is divided into sections that need to be completed by both the cardholder and the treating physician.

Cardholder Information

1. Cardholder's Name
2. Valid Until (Card Expiry Date)
3. Card Number
4. Contact Telephone Number

Treating Physician Information

1. Diagnosis
2. Date of Onset of Symptoms
3. If Hospitalised: Dates of Admission and Discharge
4. Case Management
5. Actual Cost of Treatment
6. Treatment Plan (Including Diagnostic Tests and Pharmaceuticals)
7. Physician's Name
8. Physician's Telephone Number
9. Date, Stamp, and Signature of the Physician

Checklist for Reimbursement Claim Submission

You must have the following documents before submitting your MedNet insurance claim — 

1. Completed Reimbursement Form
2. Full and Complete Medical Report
3. Diagnosis and Discharge Summary
4. Original Itemised Invoices or Receipts
5. Personal SOAP Notes (if applicable)
6. Maternity SOAP Notes (if applicable)
7. Dental SOAP Notes (if applicable)
8. Copies of Results of Diagnostic Tests

When to Resubmit Your MedNet Insurance Claims?

Sometimes, you might need to resubmit your claim. This can be the case if your claim is incomplete or if MedNet requests additional documents. 

Given below is a guide on when and how to resubmit your claims —

Reasons to Resubmit Your Claim

1. Incomplete Submission: If your initial claim was missing the required documents or information
2. Additional Documents Required: If MedNet requests more details or specific documents to process your claim

Process to Resubmit Your Claim

Visit the Official MedNet Website

• Go to MedNet Reimbursement Resubmission.

Log In

• Enter your MedNet card number, Emirates ID, or DHA card number.
• Provide your date of birth and the treatment date.
• Input the UCRN, which is provided when your claim is registered. This helps you track and manage your claim efficiently.

Upload Required Documents

• Make sure all the additional requested documents are ready for upload. These may include — 
  • Detailed medical reports
  • Original itemised invoices
  • Diagnostic test results
  • Referral letters, if necessary

Submit the Form

• Complete the form with all the necessary details and attachments.
• Verify the Google Captcha for security.

Track Your Claim

• You can track the status of your resubmitted claim online using the UCRN. Visit the Claim Tracking Page for updates.

What is the Procedure for Direct or Cashless MedNet Claims?

MedNet offers a seamless process for direct or cashless claims. This helps members receive timely medical care without making any upfront payments. 

Follow these steps to file a direct or cashless MedNet insurance claim — 

1. Visit a healthcare provider within the MedNet network. You can locate network providers through the MedNet website or its mobile app​.
2. Always carry your MedNet card. Present this card or Emirates ID to the healthcare provider to verify your eligibility for cashless services​. 
3. The healthcare provider will need to complete the SOAP (Subjective, Objective, Assessment, and Plan) form. This form is essential for cashless MedNet claims and includes —
   • Member Details and Benefit Details
   • Subjective Information: Patient's complaints and medical history
   • Pre-approval Protocols
   • Diagnostic Procedures
   • Pharmacals (Medications)
   • Patient Registration Date and Name
   • Facility Name and Telephone Number​ 
4. The healthcare provider submits the necessary documents along with the SOAP form to MedNet for approval. 

MedNet reviews the documents. After its approval, the treatment proceeds without requiring any upfront payment from the member​.

1. After the treatment, MedNet settles the bill directly with the healthcare provider for a cashless experience for the member​. 

What is the Emergency Treatment Claim Process with MedNet?

With the MedNet claim process, you can receive the necessary medical attention without delay, whether you are inside or outside the UAE.

Emergency Treatment Inside UAE

1. Visit the nearest healthcare provider within the MedNet network to receive emergency treatment.
2. Inform MedNet about the emergency as soon as possible. You can reach them via the UAE toll-free number 800 4882 (800 MedNet).
3. The healthcare provider will contact MedNet for pre-authorisation of the emergency treatment.
4. Proceed with the necessary treatment. The healthcare provider completes all required documentation, including detailed medical reports, itemised invoices, and diagnostic test results.
5. Submit the completed documentation to MedNet for claim processing. This can be done through their online portal for faster processing and tracking.

Emergency Treatment Outside UAE

1. Visit the nearest healthcare provider to receive emergency treatment.
2. Call the number on your MedNet access card for assistance. 

Note that MedNet offers 24/7 support for international claims —

• International Phone: +971 4 2757800
• Bahrain Helpline: +973 175 66 175
• Qatar Helpline: +973 175 66 175
• Kuwait Helpline: +965 222 40254
• India Toll-Free Number: 0008009713011
• Pakistan Toll-Free Number: 0080090971015

1. The healthcare provider should contact MedNet for pre-authorisation if possible. 

If pre-authorisation is not feasible due to the emergency,  gather all the necessary documentation during treatment.

1. The healthcare provider provides detailed medical reports, itemised invoices, diagnostic test results, and any other relevant documents.
2. Submit the required documents to MedNet as soon as possible. 

Claims for treatments outside the UAE must be submitted within 90 days from the date of treatment. You can upload the documents through MedNet’s online portal or send them via email to customerservice@mednet.com.