..:: Ericson Insurance TPA Pvt. Ltd ::..

1	Ericson TPA Claim Checklist
2	Ericson TPA Hospital Information Format for Empanelment
3	MOU Copy For Hospital Empanelment
4	List of Non-admissible Expenses - IRDA
5	Standard Claim Form Copy Part A ( TO BE FILLED BY INSURED )
6	Standard Claim Form Part B ( TO BE FILLED BY HOSPITALS )
7	Standard Preauth Request Form
8	Standard Claim Form Part C
9	Standard Claim Form Part D
10	Annexure A1 (CENTRAL KYC REGISTRY)
11	Chola MS Health Claim Form
12	Chola MS Cashless Pre-Auth Form
13	Claim Form Part A & B

Ericson TPA Claim Checklist

Ericson TPA Hospital Information Format for Empanelment

MOU Copy For Hospital Empanelment

List of Non-admissible Expenses - IRDA

Standard Claim Form Copy Part A ( TO BE FILLED BY INSURED )

Standard Claim Form Part B ( TO BE FILLED BY HOSPITALS )

Standard Preauth Request Form

Standard Claim Form Part C

Standard Claim Form Part D

Annexure A1 (CENTRAL KYC REGISTRY)

Chola MS Health Claim Form

Chola MS Cashless Pre-Auth Form

Claim Form Part A & B

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