For Outpatient & Inpatient Treatment

Key Points to Know

Topic	Details
Submission Process	All OPD/Inpatient treatment claims must be submitted to the Pay Accounts Office (PAO) via proper channels.
Treatment Location	State Hospitals: Claim through Regional CDA/PCDA. Private Hospitals: Claim after payment → Regional CDA/PCDA.
Jurisdiction	The nearest service hospital jurisdiction (Army/Navy/Air Force) decides which CDA to approach.
Payment	After audit, payment is authorized directly to the individual’s IRLA account.

Checklist of Required Documents

Check	Document	Notes
✔️	Appendix ‘A’ Certificate (AMA as per AO 32/81)	Properly filled
✔️	Cash Memo (Medical certificate & Receipts)	Verified by nearest Military Hospital (MH) doctor & countersigned
✔️	NAC (Non-Availability Certificate)	If MH treatment not available
✔️	Diagnostic Centre Reports	Must be NABL/NABH Accredited
✔️	Dependency Certificate (Appendix A to AO 120/80, amended 16/91)	For dependents
✔️	Contingent Bill	Must be countersigned by MH
✔️	Sanction for Tests	Must be pre-approved
✔️	Specimen Signature	Of countersigning officer
✔️	AFMSF-9 Form	For special investigations
✔️	Time-barred Sanction	If claim is late (beyond 3 or 6 months)

Outpatient Claims Process

Step	Details
1️⃣	Get treatment from Nearest MH (If available).
2️⃣	If not available → Get NAC from MH.
3️⃣	Approach nearest accredited Diagnostic Centre for required treatment/tests.
4️⃣	Collect: Medical Certificate Bills/Receipts Reports
5️⃣	Prepare Contingent Bill: < ₹5,000 → CO (Lt Col or above) can countersign. ₹5,001–₹10,000 → Col (Med)/Brig (Med)/MG (Med) countersign. ₹10,001–₹25,000 → DGMS approval needed. > ₹25,000 → Ministry of Defence (MOD) sanction required.

Important: Countersignature must be within 6 months of treatment (ideally within 3 months). Date sequence must be logical: MH ➔ NAC ➔ DC.

Inpatient Claims

Topic	Details
Hospitalisation Claims	Hospitalisation claims (State/Private) → CDA/PCDA of nearest service hospital’s jurisdiction.
Documentation	Same documentation required as for Outpatient Claims.

Common Reasons for Rejection

Reason
Missing or unsigned documents.
Time-barred claims without sanction.
Invalid or expired NAC.
Wrong authority signature.
Mismatch in names, ranks, Army Nos.

Quick Tips for Jawans

Tip
Always keep copies of every document.
Follow the proper sequence of treatment and document verification.
Don’t delay submission—apply well within time limits.
For expensive treatments (> ₹25,000), ensure MOD sanction is obtained before applying.

To Get Started: 📄 Download Medical Reimbursement Claim Checklist (PDF)