Payment and Re-imbursement of Medical expenses under ECHS; Processing of Online Bills by Bill Processing Agency (BPA)

Department of Ex-Servicemen Welfare send a circular to the Chief of Army, Naval and Air Staff regarding amendmens of the sanction amount for reimbursement of Medical expenses under ECHS.

Payment and Re-imbursement for Medical Treatment (Online Billing)

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TRAVELLING ALLOWANCE FOR ECHS PATIENTS

Ex-Servicement Contributory Health Scheme
Department of ESW, Ministry of Defence

An important order published in the official website of ECHS on 17th September, 2018 regarding the admissible of Travelling Allowance for ECHS Patients.

ECHS Travelling Allowances for Medical Treatment

In various topics a detailed order has been published for ECHS Beneficiaries such as Admissibility, Journey By Rail, Journey by Civil Air, Journey by Road, Journey by Sea or by River Steamer, Conveyance for Attendants, Organ Donor, Ambulance Charges.

Click to view the order

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GOVERNMENT OF INDIA
MINISTRY OF RAILWAYS
(RAILWAY BOARD)

No.2016/H-1/11/58/Policy

New Delhi, dated 25.4.2018

The General Managers,
All Indian Railways & Production Units,

Sub: Comprehensive procedure, guidelines and check list for empanelment of private hospitals.
Ref:- SER’s letter no.CMD/SER/Hosp. Tie-up/2303 Dated 14.11.2017.

PCMD/SER vide their letter under reference had sought necessary guidelines to be followed while empanelling private hospitals in consequence of powers delegated to the GMs for empanelment of private hospitals vide Railway Board letter no. 2017/Trans/01/Policy dated 18/10/17 and to the DRM’s for divisions and CWMs for workshops vide letter no.2017/Trans/01/Policy/Pt 1 dated 30/11/17. Such powers are to be exercised by the delegated officers in person and shall not be delegated below. Hence now no proposal for empanelment is required to be sent to Railway Board.

A comprehensive guideline for procedure and checklist to be followed while empanelling private hospitals are being issued as per Annexure enclosed. Any new guidelines issued from MoH & FW as and when issued shall be duly incorporated and advised.

This is in surprise of all earlier guidelines issued from Railway Board on this subject.

This issues with the concurrence of the Finance Directorate of the Ministry of Railways.

(Mrs. H.K. Sanhotra)
Joint Director-II/Health

Comprehensive Procedure Guideline & Check List For Empanelment of Private Hospitals

The empanelled hospitals have been broadly categorised into two groups:-

A. CGHS / E$l / ECHS empanelled hospitals and Government of India / Public Sector Undertaking hospitals like of SAIL, BHEL, Coal India, etc.

B. Other private hospitals which are neither empanelled by CGHS, ECHS & ESI nor are run by Government of India Public Sector Unit. (PSU).

The following guide lines and check list are to be kept in consideration while empanelling hospitals by Railways. The point common to both these types of hospitals are given below:-
1. Justification for the proposal mentioning the present status of Railway Hospital i.e. number of Doctors & Paramedical on roll vis. a vis. sanctioned strength, services provided by it, any future plan for expansion, no. of Honorary Consultants/Visiting Specialists (specialty wise) & CMPs and despite existing facilities why referral services are still required.

2. Justification for empanelment with technical aspect i.e. number of beds/ facilities/specialties/services offered/medical set up etc. at the proposed hospital.

3. Total number of Railway beneficiaries catered by the Railway Hospital.

4. In the Specialties Specialties for which Railway hospital do not have facilities if there are any reputed Government Hospitals rendering services in those specialties.

5. In CGHS covered states/cities, hospitals should be empanelled only at CGHS rates (in case of Government of India, PSU hospital their own rate) or even lower or some discount etc offered by them. Names of the hospital empanelled by CGHS / ECHS /ESI can be obtained from respective website. Even in places not covered by CGHS, all out efforts should be made to empanel hospital on CGHS (city-specific) rates only. In case of any deviation from CGHS rates, justification to be given by MD / CMS / CMO in charge, duly concurred by Associate Finance before being approved by Competent Authority.

6. Comparative statement of package rates as well as diagnostic charges of the proposed hospital with (i) other empanelled hospitals in the city and (ii) the CGHS rates of that city or the nearest city in tabulated form.

7. Two copies of rate list of hospital duly verified by competent authority. After approval, one copy along with sanction letter to be sent to HQ for uploading on Zonal website.

8. Concurrence of the Associate Finance as applicable along with their verbatim comments

9. Proposal to be sent for approval of GM /DG (RDSO) /DRM /CAO /CWM as the case may be (both for the first time and as well as further renewals).

10. Validity of empanelment will be two years or till it is empanelled or revoked by CGHS / ECHS /.ESI whichever is earlier and for Government of India PSU hospitals too it will be for two years, Same for non CGHS / ECHS / ESI hospitals too. Overall performance of the hospital, patient’s feedback etc. to be kept in mind while extension

11. Further extension may be done with mutual consent of both parties, arid will be sanctioned by GM /DG (RDSO) /DRM /CAO /CWM as the case may be (also see para
A((a) & B(d)).

A. CGHS / ESI/ ECHS empanelled hospitals and Government of India / Public Sector Undertaking hospitals like of SAIL’ 3HEL, Coal India, etc. –
(a) In case of CGHS / ECHS / ESI empanelled & Government of India/PSU run hospitals, a letter of willingness from the hospital be obtained and can be empanelled any time Rates as and when revised by CGHS can be agreed to.

B. Other private hospitals which are neither empanelled by CGHS, ECHS & ESI

a) An open advertisement should be floated once a year or as per requirement for empanelment of private hospitals.

b) Empanelment of such hospitals should be considered only if there is no other CGHS/ ECHS / ESI nor any hospital run by Government of India – Public Sector Undertaking like SAIL, BHEL, Coal India etc. empanelled hospital, preferably within a vicinity of 5kms from the hospital already empanelled.

c) Search committee should be constituted by MD / CMS / CMO, consisting of 3 doctors of at least JAG level and they may co-opt another doctor of particular speciality when required. They will visit the hospitals and give clear justification for approving this hospital.

d) For any increase in rates, at the time of extension same should be justified by MD/CMS/CMO and concurred by Associated Finance and accepted by the concerned competent authority. If such increase in rates is more than 5%, the proposal duly justified by medical in charge and vetted by associate finance and approval of DRM /CWM in case of Division and workshops to be sent to Headquarters for sanction of General Manger. In case of headquarter controlled Central hospitals and Pus, General Manager / DG*(RDSO) will approve such proposals. However, no enhancement in rate is permissible during that period of recognition of two years.

Source: http://www.cghs.gov.in/

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LATEST ECHS SMART CARD ONLINE APPLICATION PROCESS SIMPLIFICATION AT USER DOORSTEP

BASED ON THE FEEDBACK FROM THE ENVIRONMENT, FOLLOWING MAJOR SIMPLIFICATION MEASURES WERE INITIATED TO ENHANCE THE CONVENIENCE OF VETERANS ON 23 JAN 2018.

• AFFIDAVIT FOR DEPENDENTS, DISCHARGE / SERVICE BOOK, PART – II ORDERS FOR ADDING DEPENDENTS, BIRTH CERTIFICATE OF DEPENDENTS ALREADY DONE AWAY WITH.
• SELF DECLARATION TO BE DONE ONLINE AS PER PROFORMA ON PORTAL.

THE PROCESS IS NOW FURTHER SIMPLIFIED WEF 16 FEB 18 AS UNDER:-

• REQUIREMENT OF E-MAIL FROM THE REGISTRATION HAS BEEN REMOVED AND MADE OPTIONAL IN THE APPLICATION. HOWEVER, PROVIDING EMAIL ID IN THE APPLICATION WILL FACILITATE MEANINGFUL COMMUNICATIONS TO BENEFICIARIES.
• THE PASSWORD CONFIGURATION HAS BEEN SIMPLIFIED TO ONLY INCLUDE A COMBINATION OF AT LEAST EIGHT NUMERALS & CHARACTERS.
• ‘FORGOT PASSWORD’ FEATURE HAS BEEN ADDED WITH SECURITY QUESTIONS.
• CAPTCHA AVAILABLE IN THE REGISTRATION AND LOGIN FORM HAS BEEN SIMPLIFIED.
• DATE FIELD HAS BEEN SIMPLIFIED.
• PROVIDING OF PAN NUMBER FOR PRIMARY BENEFICIARY AND SPOUSE HAS BEEN MADE OPTIONAL. HOWEVER, PROVIDING PAN NUMBER (IF HELD) FOR OTHER DEPENDENTS IS ESSENTIAL.
• DRUG ALLERGY TO BE PROVIDED ONLY IF APPLICABLE AND IS OPTIONAL.
• TEMPORARY SAVE & EDIT OPTION HAS BEEN CREATED.
• OPTION TO DOWNLOAD FILLED APPLICATION FORM BEFORE PROCEEDING FOR PAYMENT HAS BEEN CREATED TO CROSS CHECK CORRECTNESS OF DETAILS IN THE FORM.

IMPORTANT
1. ALL ARE REQUESTED TO DOWNLOAD FILLED APPLICATION BEFORE PROCEEDING TO PAYMENT STAGE.

2. ADDING UNAUTHORISED BENEFICIARY WILL MAKE ENTIRE FAMILY INELIGIBLE ONCE DETECTED AT VERIFICATION STAGE.

Authority: www.echs.gov.in

Download link: LATEST ECHS SMART CARD ONLINE APPLICATION PROCESS

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LAUNCH OF ECHS WHATSAPP NO – 9868857972

1. Beneficiaries have following options available for seeking redressal to their grievances:-

(a) Online.

(i) CPGRAMS – Centralised Public Grievances Redressal & Monitoring System run by Department of Administrative Reforms & Public Grievances, Govt of India which can be accessed on website
http://pgportal.gov.in. Grievance related to ECHS are automatically routed to Department of Ex-Servicemen Welfare / Central Organisation ECHS.

(ii) Army Veterans Grievance Handling Portal – This portal is launched by Army Veterans Cell for redressing grievances of our esteem veterans. The web id of this portal is http://indianarmyveterans.gov.in.

(b) E-mail. E-mail to the Director (Complaint & Litigation) on his official E-mail ID dircomplaints-mod@nic.in.

(c) WhatsApp. WhatsApp No (9868857972) is functional known as “Shape Your Scheme’ and ‘Save Your Scheme’ for enhancement of effectiveness and reporting of issues by beneficiaries.

(d) Normal Post. Forward grievances at the following address :-
Director (Complaints & Litigation)
Central Organisation ECHS
Adjutant General’s Branch
Integrated HQ of MoD (Army)
Maude Lines
Delhi Cantt – 110010

(e) Helpline No. Call Helpline No. 1800114115

(f) Tele Call. Tele / Mob Nos of all appointments of Central Organisation ECHS, Regional Centres and Polyclinics are available on ECHS website.

Note :- Beneficiaries are requested to :-

(i) First approach concerned OIC Polyclinic / Stn HQs / Regional Centre for complaining and resolving the issues expeditiously.

(ii) Lodge grievances online as per Para 1 (a) above for resolving them on fast track basis and also monitoring progress on their grievances.

2. Details / address of CPIO and First Appellate Authority for RTI querries pertaining to ECHS are as under :-

(a) CPIO
RTI Cell, Addl DG AE
G-6, D-1 Wing
Sena Bhawan, Gate No -4
IHQ of MoD (Army)
New Delhi-110011

(b) First Appellate Authority
First Appellate Authority
Provost Marshal Office
AG’s Branch, IHQ of MoD
Sena Bhawan, New Delhi-110011

Authority: http://echs.gov.in/

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