Once your claim has been processed, you will receive the reimbursement advice by email; this advice will also be available on your eClaims account. We recommend reviewing it each time to ensure all details align with the rules and regulations of UNSMIS. 

Find below a summary to help you interpret the notes and indications on your reimbursement advice more easily: 

• In the top left corner, you will find your insurance number, the processing date of your claim and the claim number. Please note that the claim number changes once it is approved for reimbursement.
• In the top right corner, you will see the name and address of the paying member. It is important to note that for active staff members the address will match their duty station.
• The table section displays the reimbursement details for your treatments and examinations. Each medical expense is listed on a separate line, with the date of the treatment and the type of medical service, allowing you to verify the reimbursement rate applied.
• For details about reimbursement rates and conditions by treatment type, please refer to  Annex III of UNSMIS’s Internal Rules (available here).

The claimed amount is first shown in the currency of the invoice, followed by the equivalent in Swiss Francs (CHF) based on the United Nations exchange rate applicable on the processing date. While the reimbursed amount for expenses is always displayed in CHF, rest assured that the payment will be made in the currency recorded with your banking details. 

• The subsequent columns (Benefit CHF and Supplementary Benefit CHF) indicate the reimbursed benefits, i.e., the amount you will receive for each listed expense.
  • In some cases, the reimbursed amount will show as ‘0.00.’
  • If ’Benefit CHF’ displays ’0.00’, you will find some letters in the last column referring to the explanatory notes at the bottom of the page. In case further documents are required, please submit a new claim on eClaims by attaching the present reimbursement advice as well.
  • If the Supplementary Benefit CHF indicates ’0.00’, it means that the Supplementary Plan was not applicable. For details, please refer to Annex III of UNSMIS’s Internal Rules (available here) and consult the dedicated article, 'Supplementary Plan'.
• Below the table, you will find the total amount claimed and the reimbursable amount in CHF.
• Finally, you will see a note indicating the name of your bank and the amount to be transferred in the selected currency. If you wish to change your banking details, please consult 'How do I Change My Banking Details'.

Why has the amount I paid been divided into several lines? 

• In case your expense exceeds the ceiling applied for the treatment, it will appear in two separate lines:
  • The amount up to the ceiling with the applicable reimbursement rate.
  • The remaining amount below will indicate the portion to be fully covered by you.
• In case the total amount of the invoice includes different types of expenditures, we will need to split to amount to apply the corresponding reimbursement rates. This means that e.g., the reimbursement of a hospitalization fee may be divided into several lines: hospitalization costs, surgeon’s fees and medications. 

Can I receive the reimbursement of multiple claims in a single payment? 

Yes, if you submit several claims on the same day or within a short period of time, your claims will most probably be processed together. In case you submitted claims for your dependents as well, the expenses of each member will appear in a separate table on the reimbursement advice. 

Recovery after direct billing

When you request direct billing, we settle the bills—in most cases, through our third-party provider—directly with the medical establishment. This means that the invoices, including your share, are paid by us. Therefore, you will receive a reimbursement advice by email to inform you about the amount we paid and the amount that will be recovered from you. It is important to note that reimbursement advices related to direct payment are not available on your eClaims account, unlike those you receive for your processed claims. 

On the first page of the advice, you will find a table section, similar to the regular reimbursement advice, detailing the date, the category of the medical cost and the amount. The fee is shown first in the original currency, then in CHF, and finally, the portion we cover according to the applicable reimbursement rates. Additionally, unlike other reimbursement advices, the columns specifying the name of the provider are always filled in to help you identify the corresponding direct payment. 

The notification on the second page shows your share and provides details about the recovery. For most active staff members, the recovery is processed through Payroll. Before any deduction is made, you will also receive prior communication from Payroll. In all other cases, you will be asked to transfer the amount directly to us. A message with our banking details will be sent to you to facilitate the transfer.