How to Submit a Claim

E-Claims Portal

UNSMIS relies on its members providing accurate data in order to ensure a correct and timely settlement of claims. In 2017, UNSMIS rolled out its E-Claims portal, a portal where an insured member may submit claims electronically, verify dental and optical credit balances, issue attestations and retrieve reimbursement advices from previous reimbursements.

To better understand how the portal works and for instructions on how how to log in, please click on the following links to access the relevant documents in either English or French: EN I FR

We strongly urge all insured members to move from paper submissions to online submission of electronic claims. The advantages are that it will reduce the amount of paper used and it will facilitate submission from all over the world and thus reduce the time and costs necessary for physicalyy mailing the claims. It will create a "one-stop shop" for insured members to verify credits, retrieve old reimbursement advices, submit claims, issue attestations and verify the status of recently submitted claims.

We also strongly urge all insured members to take note of the disclaimer that spells out your duties and responsibilities (document in both English and French). Disclaimer

If you would like to access the portal directly, then please click on the following link:

https://unsmis-eclaims.unog.ch/nhiis-eClaimsPortal/

 

Please remember that 1) Claims must be submitted within twelve months from the date of invoice. and 2) Benefits are calculated according to the invoice date in the case of fees for medical services, and according to the treatment date in the case of invoices for certain services relating to benefits that are subject to an annual ceiling.

 


 

 

For those insured colleagues who still wish to submit paper claims, although we strongly discourage it, please ensure you correctly follow the below procedure.

 

For claims documentation presented in a language other than the 6 official UN languages please refer the page Language of Documentation, but please note that the below steps still apply.

 

  • A seperate claim for each insured person in your family is to be submitted
  • Original documents must be attached to the claim otherwise reimbursement will be denied. Please remember to attach originals of all invoices, prescriptions, payment receipts and other supporting documentation.
  • Avoid accumulating bills and send claims as regularly as possible.
  • With your reimbursement claim form, you must enclose your original prescriptions, bills and receipts. Duplicates, reminders, faxes and photocopies are not accepted. You must not modify, erase or write anything on your bills. The Insurance Society encourages the members to submit their medical bills as early as possible without accumulating too many invoices.
  • Always retain a copy of your own records. The Society processes over 70,000 claims per annum and requesting photocopies is a time consuming process that slows down the settlement of claims.
  • For certain medical benefits the prior authorization of the Society in writing must be requested in accordance with the Society rules. Such authorizations are only valid for a period of SIX MONTHS.
  • You must pay all expenses that entitle you to reimbursement. You may be asked to produce documentary evidence that you have paid such expenses. However, as cash payments cannot be substantiated in this way, it is in your interest to pay all expenses by cheque, credit card or postal giro (bulletin de versement), so as to avoid long delays in the event of random checks. Cash payments for expenses over CHF 500 should be avoided at all costs.
  • If you claim pharmaceutical expenses, it is important to attach to your prescription the till receipt or the receipted bill providing proof of purchase. It is also advisable to attach any stickers from the packaging of your medicine, so as to facilitate reimbursement of the medicine and avoid any disputes over its acceptability to the Society.
  • If you are hospitalized in a public medical establishment in France, you must pay all bills or fees. When you pay, you will be given the "avis des sommes à payer" for reimbursement purposes. In case of an hospitalisation in a private establishment (clinic), you should submit the "facture détaillée des frais de séjour (ref. Form 615)" .
  • You must submit reimbursement claims no more than 12 months after the billing date. You must sign and date them.
  • UNSMIS cannot accept "installment schedules for treatment" or "statement of accounts in lieu of a standard bill or invoice for medical treatment. This practice is particularly common in North America. As these cannot be accepted as a valid bill or invoice please always ask for what is called an "Insurance Claim Form", example attached.

 

 

Claim Forms—Click on the links below to access the form you need.

 

Medical Claim Form for Active Members

 Medical Claim Form for Retired Members