OPD and inpatient episodes generate different paper trails. Insurers look for different proof elements; your job is to file what matches the setting you actually used.
Typical OPD packet elements
- Consult prescription, diagnostics done the same day, and payment receipts.
- Referral note if a specialist saw you within a network chain.
- Policy-specific caps or copay notes from the TPA portal screenshot (date-stamped).
Typical hospitalisation packet elements
- Admission and discharge paperwork, itemised bill, implant stickers if applicable.
- OT notes or summaries only if your insurer’s list asks for them (redact unrelated pages if allowed).
- Pre-auth trail from admission through final bill settlement.