Health insurance claim document list

Our list of documents needed for a typical claim in Mexico

Expat Insurance has compiled a list of documents that global insurers commonly request to process your claims in a timely manner in Mexico. This is not a complete list, as insurers will request specific documents that are unique to the claim, but if you get all of these you will be in a good position. If you are hospitalized, request and collect these documents before leaving the facility.

For filing general CLAIMS, you will need to collect the following paperwork from the provider. Request it at the time of your appointment:

• *** IMPORTANT *** Factura. Doctors/hospitals are required by law to provide you with a factura, but you have only 30 days from the date of service to request this document.
• Many providers are requiring the Constancia Fiscal to provide facturas due to recent Mexican tax laws. Be sure to bring it with you to your appointment.
• Recibo with doctor’s name, address, services rendered, date of service, client’s name.
• All claims must have proof of payment, ie. credit card slip, “Pagado” stamp, etc.
• Doctor’s medical notes must clearly state the date of the onset of symptoms in, D/M/Year or M/D/Year format, diagnosis, doctor’s recommendations for, 

treatments/testing. The medical notes need to be on the doctor’s letterhead.

For Medication & Labs/Tests {in addition to above}: 

• Written prescription for medication, labs/testing.
• Receipts from the pharmacy.
• Results of labs/testing.
• Medical report/note from doctor with date of onset of symptoms and treatment recommendations, ie. “Patient came to see me when symptoms started D/M/YEAR or M/D/YEAR. I am prescribing xxx.” The date must include day, month, year.

*For surgeries, ER visits, & Overnight Admittance {in addition to above}:

• Itemized bill - breakdown cost of every item used during hospitalization.
• Operative report.
• Anesthesiologist’s notes.
• ER notes.
• Admission & Discharge notes.
• All test results.

*For Morgan White claims, they may request medical history dating back up to 3 years. Be prepared to provide that information.