FAQ - What should I do if there is a query from the Claims Team?

When the Claims Team raises a query, it will appear in the Outstanding window inside the Dashboard. Treat each query as a discrete task: read the query, gather the exact documents requested, respond via Reply Query with a clear explanation and attachments, then monitor the claim until it is resolved.

Step-by-step

1. ) Open the Dashboard Tab under the menu toggle section and find the Outstanding window to locate the query.



2.) Click the Reply Query button to respond to the query

3.) Once you click on the Reply Query button, you will be redirected to the Query Details page. Here, you will see the assigned Query Number along with the full message from the Claims Team.

Read the query carefully, note the requested documents or corrections, and follow the instructions provided.

4.) Attach the required supporting documents, submit your response through the Upload documents section to complete the process.



5.) Click the Submit button at the bottom right to submit the query. 



6.) Click Yes to confirm query reply. Do note: This will be sent to HealthMetrics for processing and cannot be undone.



7. Once you have replied to a query, it will no longer appear in the Outstanding window. However, you can always track the status of the query under the Claims tab.



In summary, always review the query carefully, prepare the required documents, and submit your response through the Reply Query page. Ensuring accurate and complete information will help expedite the claim review process and prevent further delays.