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Old 21.06.2011, 13:09
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How do I file a Sanitas claim?

Hi all,

I have a quick question for those of you who use Sanitas as your health insurance provider.

How do you put in claim?

I have received a bill directly from my GP which I would like to forward on to Sanitas so that they can put it though my health insurance.

Is there a certain procedure for sending my bill to Sanitas? Be it an address specifically for claims? Or a covering letter I should include? Do you send the original bill or a photocopy?

Iíve had a look through my insurance docs and my german is so rudimentary that I would have to type the whole thing into Google Translate to find what Iím looking for! :S

Thanks in advance for your help!

Laurie x
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Old 21.06.2011, 13:16
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Re: How do I file a Sanitas claim?

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Hi all,

I have a quick question for those of you who use Sanitas as your health insurance provider.

How do you put in claim?

I have received a bill directly from my GP which I would like to forward on to Sanitas so that they can put it though my health insurance.

Is there a certain procedure for sending my bill to Sanitas? Be it an address specifically for claims? Or a covering letter I should include? Do you send the original bill or a photocopy?

Iíve had a look through my insurance docs and my german is so rudimentary that I would have to type the whole thing into Google Translate to find what Iím looking for! :S

Thanks in advance for your help!

Laurie x
Usually you get 2 copies of the bill on one sheet of paper; half you keep (& pay) the other half you send away.
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Old 21.06.2011, 13:17
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Re: How do I file a Sanitas claim?

With my insurance company, I have to pay the bill and send evidence of payment (with a copy of the bill) to the insurance company. They may, or may not, refund me at a later date.
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Old 21.06.2011, 13:24
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Re: How do I file a Sanitas claim?

Thanks for your reply.

Surely I donít pay the bill if itís come direct from my GP and I want Sanitas to pay it?

Iím just unsure where I am supposed to send the bill to for Sanitas and whether there is some kind of covering letter I am supposed to include.

Thanks

Laurie x
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Old 21.06.2011, 13:26
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Re: How do I file a Sanitas claim?

That sounds sensible!

Although I had been told by someone when I first applied for Sanitas that I shouldnít pay any bills directly, and that I should send off my bills for Sanitas to payÖ I just canít find any info on where I send these bills and what iím supposed to include. Feel like a dumbass!

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With my insurance company, I have to pay the bill and send evidence of payment (with a copy of the bill) to the insurance company. They may, or may not, refund me at a later date.
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Old 21.06.2011, 13:27
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Re: How do I file a Sanitas claim?

Normally you have to pay it first- check with your Insurance, as they are all different. Re-imbursement also depends on your 'franchise' - our is 500CHF, so we have to pay the first 500CHF each year, before the insurance kicks in. So far we've never exceeded that - so paid all bills for doctor's and drugs.
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Old 21.06.2011, 13:33
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Re: How do I file a Sanitas claim?

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Normally you have to pay it first- check with your Insurance, as they are all different. Re-imbursement also depends on your 'franchise' - our is 500CHF, so we have to pay the first 500CHF each year, before the insurance kicks in. So far we've never exceeded that - so paid all bills for doctor's and drugs.
Thanks for your reply. Thatís kind of what Iím asking, whether anyone who uses Sanitas knows what I have to do.

I have a massive excess on my insurance (1000chf+) but I want this bill to come out of my excess as it would seem that Iím going to need further treatment this year that will eventually use up my excess anyway, so it seems to make sense to claim all bills thorough Sanitas.

All I really need to know from any Sanitas users, is what they do when they claim?

Thanks for your help!

Laurie x
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Old 21.06.2011, 13:55
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Re: How do I file a Sanitas claim?

I have Sanitas insurance. With the policy I have, I need to pay all bills myself and send a copy/original to Sanitas. I am reembursed later for the bill.

Your policy might be different, though.
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Old 21.06.2011, 13:57
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Re: How do I file a Sanitas claim?

Would be interested in a reply from Sanitas members. For our Insurance- they will not pay bills until you've exceeded your excess- irrespective of any 'anticipated' further treatment. So if your first bill is. say, for CHF 1200, they would only pay the 200. With most insurances the excess is down to you.

Edit, Helm, posts crossed. What excess do you have on your policy - surely the re-imbursement will only take place once you've gone beyond that excess.
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Old 21.06.2011, 14:00
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Re: How do I file a Sanitas claim?

Sanitas policy example:

I have a franchise of CHF1000

- Everything until I sum a total of CHF1000 must be paid by me
- Everything over CHF1000 will be paid (as in reembursed later) by Sanitas. A 10% (?) (don't remeber anymore the currect percentage, will check later) will have to be paid by you NO MATTER WHAT. So even over those CHF1000 you get paid a max of 90% (?)

This, by the way, is the very basic policy. They have other possibilities, which are more expensive. But just a gorgeous example:

You may take an extra policy for people with glasses, paying about 200 CHF per year as "glasses insurance". If your glasses brake or you need new ones, they pay 60%. I find it ridiculous because people in my family change glasses at a maximum 1 time every 3 years (that's 600 CHF wasted since their glasses never costed more than 300CHF...)

Last edited by Helm; 21.06.2011 at 14:14. Reason: Wrong pronouns...
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Old 21.06.2011, 14:02
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Re: How do I file a Sanitas claim?

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they will not pay bills until you've exceeded your excess- irrespective of any 'anticipated' further treatment.
True, but as a customer, if you know for certain that you will be submitting further claims later in the year it is worth your while submitting everything you can before then in order to make up your excess ready for the big bill onslaught.

If you knew you'd only be using 100 CHF worth of medication in a year, then you might never bother to send your bills in. If you knew that you'd be sure to run up bills of several thousand francs, you'd want to send everything in, right from the start.
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Old 21.06.2011, 14:02
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Re: How do I file a Sanitas claim?

When you took out your insurance they should have sent you a sheet of peel off labels. Each label has three boxes and you're supposed to tick one of them. The boxes are "accident", "sickness" and "maternity." You stick the label on the doctor's bill and tick the appropriate box. Then pay the bill at the post office and staple the franked counterfoil to the bill. Then send it off to Sanitas. They should also have sent you peel off labels with their address to stick on the envelope. If you haven't got the labels, give them a call.
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Old 21.06.2011, 14:02
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Re: How do I file a Sanitas claim?

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Would be interested in a reply from Sanitas members. For our Insurance- they will not pay bills until you've exceeded your excess- irrespective of any 'anticipated' further treatment. So if your first bill is. say, for CHF 1200, they would only pay the 200. With most insurances the excess is down to you.

Edit, Helm, posts crossed. What excess do you have on your policy - surely the re-imbursement will only take place once you've gone beyond that excess.
Hi Odile,



Sorry, I think I just explained it badly. I am still expecting to have to pay the bills in full, as I havenít reached my excess. However, I would like to send my bills to Sanitas so that they can file them and then bill me. This way, I will be starting to use up some of my excess rather than simply paying the GP bill directly. Essentially, I just want all of these GP and specialist bills to go through Sanitas first. So my question is, how do I do that?

Thanks so much for your help!

Laurie x
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Old 21.06.2011, 14:05
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Re: How do I file a Sanitas claim?

Quote:
True, but as a customer, if you know for certain that you will be submitting further claims later in the year it is worth your while submitting everything you can before then in order to make up your excess ready for the big bill onslaught.

If you knew you'd only be using 100 CHF worth of medication in a year, then you might never bother to send your bills in. If you knew that you'd be sure to run up bills of several thousand francs, you'd want to send everything in, right from the start.

Eeeexactly!

So all iím asking of those Sanitas users, is how I send these bills into Sanitas so that they can bill me?

Thanks Dougalís Breakfast. I was struggling to explain what I wanted to say!

Laurie x
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Old 21.06.2011, 14:09
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Re: How do I file a Sanitas claim?

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When you took out your insurance they should have sent you a sheet of peel off labels. Each label has three boxes and you're supposed to tick one of them. The boxes are "accident", "sickness" and "maternity." You stick the label on the doctor's bill and tick the appropriate box. Then pay the bill at the post office and staple the franked counterfoil to the bill. Then send it off to Sanitas. They should also have sent you peel off labels with their address to stick on the envelope. If you haven't got the labels, give them a call.
Thanks Nev. Thatís what I was looking for.

So, I have some address labels to stick to the envelopes, as does my husband. However, neither of us have ever had any stickers with boxes to tick, which leads me to believe that I am supposed to send of my bills to Sanitas for them to process and bill me directly?

I used the GP last year but they sent my bill directly to Sanitas (missing me out all together), Sanitas then billed me. Annoyingly, this time round, my GP sent the bills direct to me. Iím worried that if I pay them, I wonít be able to put them through Sanitas.

Confused!?

Laurie x
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Old 21.06.2011, 14:16
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Re: How do I file a Sanitas claim?

Why don't you phone them and find out? I'm with Sanitas and always get an English speaker on the phone.
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Old 21.06.2011, 14:19
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Re: How do I file a Sanitas claim?

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Thanks Nev. Thatís what I was looking for.

So, I have some address labels to stick to the envelopes, as does my husband. However, neither of us have ever had any stickers with boxes to tick, which leads me to believe that I am supposed to send of my bills to Sanitas for them to process and bill me directly?

I used the GP last year but they sent my bill directly to Sanitas (missing me out all together), Sanitas then billed me. Annoyingly, this time round, my GP sent the bills direct to me. Iím worried that if I pay them, I wonít be able to put them through Sanitas.

Confused!?

Laurie x
Normally, you get two copies of the bill from your doctor.

The one that says 'copy', you keep for your records, and you send the other to your insurance.

You also pay the payment slip that is sent to you, and your insurance reimbourses you, virtually all Swiss insurance companies work this way.

However, hospital bills go first to the insurance, who then bills you.

Tom
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Old 21.06.2011, 14:25
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Re: How do I file a Sanitas claim?

Nearly all Dr's used to bill the insurance companies directly but that has been changing for years now, Dr's generally now send all bills directly to their patients. The patient i.e. you, then have to pay the bill yourself and then pass the bill onto your insurance company who will then decuct the relevant amount from your franchise or will reimburse you by bank transfer once you are over the franchise amount.

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Thanks Nev. Thatís what I was looking for.

So, I have some address labels to stick to the envelopes, as does my husband. However, neither of us have ever had any stickers with boxes to tick, which leads me to believe that I am supposed to send of my bills to Sanitas for them to process and bill me directly?

I used the GP last year but they sent my bill directly to Sanitas (missing me out all together), Sanitas then billed me. Annoyingly, this time round, my GP sent the bills direct to me. Iím worried that if I pay them, I wonít be able to put them through Sanitas.

Confused!?

Laurie x
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Old 21.06.2011, 14:27
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Re: How do I file a Sanitas claim?

You would normally receive two copies of your bill from the doctor. In all cases you should send a copy of the bill to Sanitas. All you have to do is to write your relevant police number on the bill and send it to

Sanitas
Service Center Winterthur
Konradstrasse 14
Postfach 299
8401 Wintherthur.

Small amounts should be paid by you and the bill sent to Sanitas. In all cases Sanitas will reply back to you with a notice showing how much of you deductible has been used up. For Large amounts the hospital or Doctor would normally send the bill to Sanitas and they will pay it and send you a bill for the excess amount owing to them. ( This is normally Debited or Credited to your account if you have an LSV set up.)
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Old 21.06.2011, 14:33
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Re: How do I file a Sanitas claim?

I've been with Sanitas for more than 15 years and you should listen to Coolio :-)
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