Sample Medical Bill Reimbursement Application Format
[Here briefly focus on Medical bill reimbursement application format. You can also follow these as a covering letter for medical claim requesting reimbursement of medical expenses. You can modify this format as your requirement.]
Date…
Human Resource,
Medical Institution name…
Institute Address…
Sub: Application for Medical Bill Reimbursement
Dear Sir,
I was suffering from chronic Kidney disease (Disease name) from last few months. I have operated from (medical institute name). Total expense (Money amount) are incurred. Please reimburse this amount; I have attached all the necessary documents and Invoices.
I shall be highly grateful to you.
Name…
Job Designation…
Address and contact no…
Signature…
Another format,
Date…
Administration Office,
Medical Institution name…
Institute Address…
Sub: Request for Medical Bill Reimbursement
Dear Employer’s Name,
I am sending this letter to request reimbursement for the applicable medical expenses I have incurred due to (disease name). I was admitted to the (Name of Hospital), for five/seven days. I am enclosing all medical records pertaining to my treatment and hospitalization as well as the amount I am requesting for reimbursement for your perusal.
I hope to hear from you within 10 business days. If you need more information, you may reach me at (contact no) or at Name@email.com. I will be happy to supply any more information you require.
I appreciate your time and support.
Name…
Job Designation…
Address and contact no…
Signature…
