Medical Reimbursement Rules, Application Form, How to Apply

MEDICAL REIMBURSEMENT FACILITY TO AP GOVT EMPLOYEES. Here the Complete Details of Medical Reimbursement Facility, How to Process medical reimbursement, how to apply for medical reimbursement are discussed.. These rules may be called the "AndhraPradesh Medical Attendance Rules,1972.Medical reimbursement is a facility where an employer reimburses uninsured general medicine or accident expenses incurred by the employee or his dependents. Government have issued Andhra Pradesh Integrated Medical Attendance Rules, 1972, applicable to State Government employees and their dependents, employees of local bodies, students of Medical Colleges, members of State Legislature, A.I.S. Officers, A.P. State Higher Judicial officers etc. Many private hospitals both in the State and out side the State have been recognised as referral hospitals, for the treatment to the above category of persons on reimbursement basis. Here the Complete Details of Medical Reimbursement Facility, How to Process medical reimbursement, how to apply for medical reimbursement are discussed. Rules and Guidelines related to Medical Reimbursement.

Medical Reimbursement Rules, Application Form, How to Apply

As per Rc.No.8878/ (D3-4) MB1 – 2010 Dated: 12-10-2010 Sub: - School Education Department – Medical Attendance – Medical Reimbursement proposals in respect of Teachers/HM’s and other Employees of Education Department – certain Instructions – Regarding. 
Read: 1.Procs.Rc.No.8878/D3-4/2009,dated:02.09.2009 and 2. Procs. Rc.No.8878/D3-/2009, dated:28.01.2010. Medical Reimbursement Proposal should be sent within 6 Months from the Date of discharge. The procedure and required forms are given below.
The Bill resulting Below Rs. 50000 should be sent to the concerned District Educational Officer and the Bills above Rs. 50000 should be sent to the C&DSE directly through Online Mode.

The DDO should arrange and to submit the proposal in the following order serially. 
  • 1. Forwarding Letter 
  • 2. Applications Requisition of individual with date 
  • 3. Check list duly attested by the Forwarding Officer 
  • 4. Appendiw-II duly signed by the Employee/Pensioner and attested by the Forwarding Officer 
  • 5. Non-Drawal Certificate in Prescribed proforma as communicated vide reference read above 
  • 6. Dependent Certificate as required in prescribed proforma which as communicated vide reference read above with Forwarding Officer signature 
  • 7. P.P.O.(Pension Payment Order) copy in case of pensioner/family pensioner attested by the Forwarding Authority 
  • 8. In case of accident cases and treatment taken in un-recognized hospitals under emergency, FIR should be submitted 
  • 9. For every follow up treatment for post operative cases and who requires lifelong treatments, revalidation of prescription once in six month from special Government Doctor attested by Forwarding Officer 
  • 10. Legal Heir Certificate should be submitted in case of death of the Teachers/Pensioners/Dependents duly attested by the Forwarding Authority 
  • 11.A copy of proceedings Issued by the Director of Medical Education for recognition of the hospital 
  • 12. Emergency Certificate/O.P in original duly signed with stamped by the treating doctor attested by Forwarding Officer 
  • 13. Essentiality Certificate in original duly signed with stamped by the treating doctor attested by Forwarding Officer 
  • 14. Discharge Summery/Discharge Memo.(OP card in respect of OP treatment) in original duly signed with stamped by the treating Doctor attested by Forwarding Officer 
  • 15. Abstract of Bills (All original Medical Bills should be signed with stamp by the treating Doctor) attested by Forwarding Officer. 
  • 16. Details proposal along with justification/need in case of claims where relaxation of rules in involved
     Further, all the District Educational Officers in the State are requested to direct all the Drawing and Disbursement Officers in their instructions to furnish to the proposal in triplicate to the Commissioner and Director of School Education (Original plus Two (2) sets of Xerox copies should be attested by the Forwarding Authority including Medical Bills). One set of Xerox copies of Bills shall, invariably, be kept with the Forwarding Officer even after the disposal of the claim. Separate proposal for the treatment obtained at NIMS/SVIMS/RIMS and other private recognized hospitals shall be submitted. They are further requested to arrange the proposal in the above order only serially numbered(model copy enclosed).

Important Orders and Rules on Medical Reimbursement given below to download


MEDICAL REIMBURSEMENT APPLICATIONS- SOFTWARESMEDICAL REIMBURSEMENT USEFUL LINKS

MEDICAL REIMBURSEMENT-Enclosures needed with Medical Reimbursement proposals

The Medical Reimbursement should be submitted to this office with the following documents

1. Annexure – II (with amount, signature of the applicant and attestation)
2. Emergency certificate (with signature and stamp of hospital/treated doctor)
3. Essentiality certificate (with signature and stamp of hospital/treated doctor. The amount in the Essentiality
Certificate should tally with amount in the Annexure-II).
4. Discharge Summary (with signature and stamp of hospital/treated doctor)
5. Out Patient Card if treatment taken as Out Patient.
6. Dependent and Non-drawal certificates (with attestation of the forwarding authority and signature of the
applicant).
7. For every follow up treatment for post operative cases, who requires life long treatments, the concerned patient has to get revalidation of prescriptions once in six months from the specialist Government doctor.
8. In case of accident cases and treatment taken in un-recognised hospitals under emergency, FIR should be
submitted.
9. Legal Heir certificate should be submitted in case of death of the teacher.

Address:
DIRECTORATE OF MEDICAL EDUCATION,
DM&HS CAMPUSKOTI A.P, HYDERABAD.
Tel: 9140-24602514/15/16
FAX No: 24650942
E-mail: dir_mededu@ap.gov.in

Government Orders and Memos issued on Medical Attendance

( From 1981 to 2010 )
G.O.Ms.No.35, M&H (K1) Department, Dated. 29-01-1981 Facilities of admission and treatment to pensioners
G.O.Ms.No. 718, M&H (K1) Department, dated 29-11-1981 Facilities of Admission and Treatment to Pensioners
U.O.Note No. 5436-A/167/A&L/82-1 Fin. & Plg. Department, Dated 30-03-1982, Reimbursement of expenditure Instructions.
Memo No. 39027/724/B4/82 Fin. Department, Dated. 21-0-1982 Debiting expenditure to the Service Head of Account.
G.O.Ms.No. 237, M & H (E2) Department, Dated. 25-03-1986 Process of Medical Aid in NIMS
U.O.Note No. 3142/K1/85-1 M&H Department, Dated. 17-04-1986 Spl., Cases, Relaxation of rules should be referred to the Govt.,
G.O.Ms.No. 609, HM & FM (E2) Department, Dated. 21-11-1988 Conditions to references to NIMS
Memo No. 69/K1/89-1 H.M & F.W Department, Dated.14-03-1989 Treatment underwent in the Apollo Hospital, Madras act.
G.O.Ms.No. 281, H.M & F.W (K1) Department, Dated. 01-05-1989 Rs. 40,000/ for Medical reimbursement
G.O.Ms.No 580 H.M & F.W (SCK) Department, Dated. 30-09-1989 Free Medical Treatment to the members of weaker sections
Memo No. 2113/K1/89-1 H.M & F.W Department, Dated. 04-10-1989 Undergo Treatment outside the State - Instructions
G.O.Ms.No. 401 H.M & F.W (K1) Department, Dated. 25-06-1991 Medical Facilities for Pensioners NIMS
G.O.Ms.No 45 H.M & F.W (E2) Department, Dated. 19-07-1991 Ailments for Direct Admission to NIM (amended in G.O.Ms.No. 373 Dated. 05-10-1995)
Lr.No 2706/K1/92-1 HM & FW Department, Dated. 30-01-1992 Reimbursement of expenditure simplification of procedure
G.O.Ms.No. 184 HM & FW (K1) Department, Dated.02-04-1992 Reimbursement Raising of ceiling to Rs. 50,000/-
G.O.Ms.No. 86 F & P Department, Dated. 01-06-1992 Heads of Departments for sanction of Medical Advance
G.O.Rt.No. 1350 Edn., Department, Dated. 24-07-1992 Extension to the teaching and non-teaching staff of A.P.R.E.I
G.O.Ms.No. 276 H.M & F.W Department, Dated. 11-05-1993 Artificial limbs, Hearing Aids etc., reimbursement
G.O.Ms.No. 403 H.M & F.W (E2) Department, Dated. 26-07-1993 Inclusion of SVIMS as referral Hospital
G.O.Ms.No. 544 H.M & F.W (K1) Department, Dated. 09-11-1993 Medical Attendance to employees at Sri Venkateswara Institute
G.O.Ms.No. 579 H.M & F.W (K1) Department, Dated. 01-12-1993 Medical Attendance to the pensioners and their dependants
G.O.Ms.No. 223 H.M & F.W (K1) Department, Dated. 23-04-1994 Reimbursement of Treatment for second time
G.O.Ms.No. 373 H.M & F.W (K1) Department, Dated. 05-10-1995 Coronary Artery Disease - included in the list ailments.
G.O.Ms.No. 38 H.M & F.W (K1) Department, Dated. 23-01-1996 Treatment in Private Hospitals.
G.O.Ms.No. 199 H.M & F.W Department, Dated. 16-05-1996 L.V.Prasad Eye Institute as referral Hospital for Eye disease
G.O (P) No. 258 H.M & F.W (K1) Department, Dated. 15-06-1996 Durgabai Deshmukh Hospital as referral Hospital
Memo No. 11007/56/Admn. II/97 F & P FW Dated. 11-04-1997 Medical reimbursement P.RP.R. Employees Clarification
G.O.Rt.No. 713 H.M & F.W (K1) Department, Dated. 22-05-1997 Bibi General Hospital and Cancer Centre Hyderabad and Citi Cardiac Research Centre Vijayawada, Recognized as referral Hospitals
G.O.Ms.No. 175 H.M & F.W (K1) Department, Dated. 29-05-1997 20% on eligible amount incases without referral from NIMS and SVIMS
U.O.Note.No. 15422/A1/97-2 H.M & F.W Department, Dated. 07-07-1997 Reimbursement of treatment Instructions
G.O. (P) No.113 HM & FW (K1) Department dated 25-4-1998 Panchakarma treatments at lakshmi Ayurveda Hospital, Hyderabad.
G.O.Ms.No. 150 HM & FW (K1) Department, Dated.20-05-1998 Reimbursement of Medical Expenses in Private Hospitals
G.O.Ms.No. 151 H.M & F.W (K1) Department, Dated. 21-05-1998 Collection of User Charges in District & Area Hospitals.
G.O.Ms.No. 154 H.M & F.W (K1) Department, Dated.21-05-1998 Medical Reimbursement for Employees and their dependents
G.O.Ms.No. 402 H.M & F.W (K1) Department, Dated. 03-09-1998 Swatantra Hospital, Rajamundry as Referral Hospital
G.O.Ms.No. 542 Edn (UE-I .I) Department, dated 20-11-1998 Extension of A.P.I.M.A. Rules to the non teaching staff of Universities
G.O.Ms.No. 578 HM &FW Department, dated 10-11-1999 Reimbursement of charges for Red cross institute of yoga and Nature Hyd.
G.O.Ms.No. 614 HM&FW Department, dated. 15-12-1999 Recognition of Lakshmi Ayurveda Hospital, Vanasthalipuram, Hyderabad as a referral Hospital
Memo No.525/SC.F/99-3(LA&SCP) Department, Dated. 24-1-2000 Re-imbursement of Medical expenditure to pensioners and members of their families
G.O.Ms.No.161 HM & FW (K1) Department, dated 5-5-2000 Maximum Ceiling enhanced from Rs.50, 000 to 75,000
G.O.Ms.No. 373 HM & FW (K1) Department, Dated. 20-10-2000 20% Cut on amount for the treatment at Private Recognized Hospitals
G.O.Ms.No.449 HM& FW (K1) Department, Dated. 24-11-2000 Usha Mullapudi Cardiac Centre as referral Hospital
G.O.Ms.No. 16 HM & FW (K1) Department, Dated. 10-1-2001 Medical Re-imbursement of retired employees Place last worked or settled after retirement permission.
G.O.Ms.No. 38 HM & FW (K1) Dept DATED. 24-3-2001 A.P. Super Speciality Dental Hospital
Memo No. 1815/K1/2001-1 HM & FW Department, Dated. 24-3-2001 Re-imbursement of expenditure Clarification.
G.O.Ms.No. 133 HM &FW (K1) Department, Dated. 9-4-2001 Indo-American Cancer Institute as referral Hospital
G.O.Ms.No. 134 HM & FW (K1) Department, Dated. 9-4-2001 Re-imbursement of expenditure for all disease with out referral letter.
G.O.Ms.No. 196 HM & FW (K1) Department, Dated. 24-5-2001 Global Hospital as referral Hospital.
G.O.Ms.No. 223 HM & FW (K1) Department, Dated. 16-6-2001 Care Hospital Vanasthalipuram as referral Hospital
G.O.Ms.No. 282 HM &FW (k1) Department, Dated. 13-7-2001 Aditya Hospitals, Hyd as referral Hospital
G.O.Ms.No. 328 HM & FW (K1) Department, Dated. 23-08-2001 Aware Hospitals, Hyderabad. As referral Hospital
G.O.Ms.No. 329 HM & FW (K1) Department, Dated. 23-08-2001 Mythri Multi Specialty Hospital, Hyderabad, as referral Hospital
G.O.Ms.No. 331 HM & FW (K1) Department, Dated. 23-08-2001 Jaya Hospital, Hanmakonda as referral Hospital
G.O.Ms.No. 332 HM & FW (K1) Department, Dated. 23-08-2001 Apollo Hospitals, Heart and Kidney Centre, Visakapatnam, as referral hospital
G.O.Ms.No. 372 HM & FW (K1) Department, Dated. 01-10-2001 Bollineni Ramanaiah Memorial Hospital Nellore as referral Hospital
G.O.Ms.No. 462 HM & FW (K1) Department, Dated.11-12-2001 Image Hospitals, Hyderabad as referral Hospital
G.O.Ms.No. 471 HM & FW (K1) Department, Dated. 19-12-2001 Reimbursement of Medical Bills upto Rs.10, 000/- to Secretariat employees Dispensing with the Security by D.M.E
G.O.Ms.No. 488 HM & FW (K1) Department, Dated. 22-12-2001 Reimbursement of Medical Expenditure to MLAs/MLCs Amendment
Lr., to A.P.S.G Retired employees Association Dated. 03-01-2002 Concession on treatment charges to retired employees at Bibi General Hospital Hyderabad
G.O.Ms.No. 4 HM & FW (K1) Department, Dated. 09-01-2002 Image Hospitals, Hyderabad as referral hospital for ESI scheme
G.O.Ms.No. 5 HM & FW (K1) Department, Dated. 09-01-2002 Prathima Institute of Medical Science, Karimnagar as referral hospital for ESI scheme
Memo No. 40482/204/A2/2001 Finance Department dated 06-02-2002 Medical Re-imbursement claims Clarification
G.O.Ms.No. 36 HM & FW K1) Department dated 13-02-2002 Prathima Institute of Medical Sciences, Nagnur, Karimnagar as referral Hospital.
G.O.Ms.No. 58 HM & FW (K1) Department dated 01-03-2002 Raising of Maximum Ceiling limit from Rs. 75,000 to Rs. 1,00,000
G.O.Ms.No. 171 HM & FW (K1) Department dated 06-04-2002 Re-imbursement of Medical expenditure to AIS officers Revised Orders
G.O.Ms.No. 169 HW & FW (K1) Department dated 18-05-2002 Charithasri Hospitals, Vijayawada as referral Hospital.
Rc.No. 1210/C3-2/2002 D.S.E dated 26-06-2002 Medical Reimbursement Proposals - Instructions.
Rc.No. 1210/C3-2/2002 D.S.E dated 04-07-2002 Medical Reimbursement proposals in respect of School Assistants and S.G.Ts.
Rc.No. 2802/D3-3/2002 D.S.E dated 04-08-2002 Reimbursement of Medical expenditure for Teachers
G.O.Ms.No. 339 HM & FW (K1) Department date 08-08-2002 Vijay Health Care Hospital, Secunderabad as referral Hospital
Memo No. 23084/IC/2002, G.A., Department dated 9-8-2002 Medical Reimbursement claims Secretariat Business Rules.
Lr.Rc.No. 20929/M.A./D.M.E., A.P., Dated 10-10-2002 Reimbursement of Medical Expenses in Government Hospitals for out patients
G.O.Ms.No. 459 HM & FW (K1) Department Dated 9-12-2002 Medical Facilities to MPs and Ex-MPs in all Government District Hospitals
G.O.Ms.No. 462 HM & FW (K1) Department Dated 9-12-2002 Yashoda Hospital, Somajiguda, Hyderabad as referral Hospital
G.O.Ms.No. 40 HM & FW Department dated 3-3-2003 Scrutiny of Medical Bills Instructions.
G.O.Ms.No. 3614 HM & FW Department dated 15-04-2003 Scrutiny of Medical Bills Instructions
G.O.Ms.No. 137 HM & FW (K1) Department Dated 5-5-2003 Reimbursement of Medical expenses to AIS Officers borne on A.P., Cadre
G.O.Ms.No. 25 L.E.T & F Department dated 12-5-2003 Yashoda Hospitals, Hyderabad for treatment of ESI Patients.
G.O.Ms.No. 309 HM & FW (K1) Department dated 4-7-2003 Reimbursement of full expenditure to High Court Judges
G.O.Ms.No. 378 HM & FW Department dated 15-7-2002 FMS Dental Hospital, Hyderabad as referral Hospital
G.O.Ms.No. 464 HM & FW Department dated 18-8-2003 smilne Dental Hospital, Hyderabad as referral Hospital
G.O.Ms.No. 465 HM & FW (K1) Department dated 18-8-2003 Committee Constituted for revision of A.P.I.M.A., Rules
Memo No. 20203/567/TFR/2003 Finance Department dated 26-08-2003 Reimbursement of Bills Violation of procedure Instructions
G.O.Ms.No. 479 HM & FW Department dated 29-8-2003 Sai Vani Hospital, Hyderabad as referral Hospital
G.O.Ms.No. 484 HM & FW Department Dated 3-9-2003 Sai Krishna Super Specialty Neuron Hospitals, Hyderabad as referral Hospital
G.O.Ms.No. 485 HM & FW Department Dated 3-9-2003 Rohin Medicare (Pvt.,) Ltd., Hyderabad as referral Hospital
G.O.Ms.No. 493 HM & FW Department Dated 11-9-2003 Rainbow Childrens Hospital, Hyderabad as referral Hospital
G.O.Ms.No. 601 HM & FW Department dated 15-10-2003 Medical Reimbursement upto third spell
Memo No. 31188/Accts. II/A1/2002-1 dated 13-11-2003 Payment of Medical Reimbursement for Non Teaching Provincial zed staff of MPs/ZPs
G.O.Ms.No. 672 HM & FW (K1) Department dated 14-11-2003 Recognition of Saumya Apollo Hospital, Tadepally as referral Hospital
G.O.Ms.No. 674 HM & FW (K1) Department 15-11-2003 Permitting bills upto Rs. 5,000 in Grey Hounds Hospital, Hyderabad
G.O.Ms.No. 677 HM & FW (K1) Department dated 17-11-2003 Ameerpet Super Speciality Dental Hospital, Hyderabad as referral Hospital
Rc.No. 5389/D1-1/2002-2 DSE dated 8-1-2004 Scrutiny of Bills for Reimbursement to Teachers
Memo No. 26814/K1/2003-1 HM & FW Department dated 16-01-2004 Reimbursement to the Family Pensioners not entitled
G.O.Ms.No. 37 HM & FW (K1) Department dated 31-01-2004, Eight Private Hospitals Recognized for Treatment to the Employees/Pensioners Residing at New Delhi
G.O.Ms.No. 41 G.A. (Spl) Department, dated 19-2-2004 Authorization for scrutiny of medical bills upto Rs. 10,000
G.O.Ms.No. 105 HM & FW Department, dated. 18-3-2004 Remedy Heart Institute, Hyd as referral Hospital
G.O.Ms.No. 119 HM & FW (K1) Department, dated. 29-3-2004 Kshema Speciality Dental Hospital, Hyderabad as referral Hospital
G.O.Ms.No. 119 HM & FW (K1) Department dated 29-03-2004 Dr. Gouds Dental Hospital, Hyderabad as referral Hospital
G.O.Ms.No. 174 S.G. (SC.X) Department dated 15-07-2004 Re-imbursement to AIS Officers borne on the Cadre of A.P.,
G.O.Ms.No. 254 HM & FW (R2) Department dated 18-08-2004 Lakshmi Ayurveda Hospital, Hyderabad as referral Hospital
Memo No. 4244/78/TFR-1/04 Fin., Department dated 20-08-2004 Clarification on Violation of Procedure for Re-imbursement of Medical Bills
G.O.Ms.No. 413 G.A. (Poll.D) Department dated 09-12-2004 application of APIMA Rules to the members of A.P., Legislative Assembly
G.O.Ms.No. 437 G.A. (SC.X) Department dated 31-12-2004 Re-imbursement of Medical expenses to the AIS Officers borne of A.P., Cadre
G.O.Ms.No. 74 HM & FW (K1) Department dated 15-03-2005 Revised APIMA Rules
G.O.Ms.No. 162 HM & FW (K1) Department dated 23-05-2005 Guidelines for recognition of private Hospitals as referral Hospitals
Memo No. 7099/K1/2005 HM & FW Department dated 14-06-2005 Clarification on Revised APIMA Rules
G.O.Ms.No. 249 G.A. (SB) Department dated 20-06-2005 Enhancement of Medical Re-imbursement to MLAs/Ex.MLAs/Ex.MLCs and members of their families raised to Rs. 1.00 lakhs
G.O.Ms.No. 180 HM & FW (K1) Department dated 11-05-2006 Maximum re-imbursement limit as Rs. 1.70 lakhs as per CGHS rates