The State Government has made certain amendments in the rates for services to be provided for treatment of beneficiaries holding smart cards under National Health Insurance Scheme and Chief Minister Health Insurance Scheme. Director, Medical Services, Dr Kamal Preet Singh said.
As per the amendments, a hike of four to 200 per cent had been made in the rates for treatments for a total of 272 packages under the schemes. In the previous package a total of 22 packages were included in the schemes.
The package rate for both Chief Minister Health Insurance Scheme and National Health Insurance Scheme would be similar while offering treatment to the beneficiaries. The new rates would be effective from April 1, 2013.
In order to implement the new rates, a workshop was organised for the representatives of registered hospitals on March 28 at the new circuit house which was also attended by representatives of insurance companies, TPA and the State Nodal Agency. The workshop was chaired by Director, Medical Services, Dr Kamal Preet Singh who removed doubts of the participants of the workshop on various issues.
On the occasion, MoUs were also signed between the representatives of insurance companies and the registered hospitals for the new rates to be made effective from April 1, 2013.The new rates had also been published on the websitewww.cg.nic.in/healthreby.
Speaking on the occasion, Singh said that registration for those hospitals who do not agree with the new rates for the schemes would be cancelled and a recommendation would be sent to the State Government to cancel their registration also for other Government schemes.
The workshop discussed claim payment procedure with a presentation made by the State Nodal Agency on the design of the website to make the system more efficient and transparent.
Every hospital would have to log into the website of the Chhattisgarh Government for which a login ID and password would be provided from which they can view information on payment made by the insurance companies, claims made by the hospitals and present the details before the insurance company and the State Nodal Officer.
The insurance companies would have to settle the claims within 31 days of the receipt of the claims and inform about cancelled claims to the concerned hospitals within 10 days.
The hospitals which had earlier expressed resentment over the proposed rates have now provided their consent over the new rates and hospitals are Gupta Hospital, Ojasvi Hospital, Rrameshwaram Hospital Dhamtari, Amrit Kalash Hospital, Durg, Jan Swasthya Sahayog , Bilaspur, Roop Jeewan Hospital, Raipur, Prabha Nursing Home and Goraj Children Hospital, Kavardha. The hospitals have provided written consent to participating in the schemes.
Dr Singh further stated that under the fourth phase of National Health Insurance Scheme the 10 districts mainly — Durg, Balod, Bemetara, Sarguja, Surajpur, Balrampur, Bilaspur, Mungeli, Gariyaband, Baloda Bazar and Raipur have private hospitals where the claim amount is being received.
There would be similar type of medical services provided to smart card holder patients of both National Health Insurance Scheme and Chief Minister Health Insurance Scheme, he said. Moreover, Chhattisgarh would be the only State where all families would be provided the benefit of health protection, Singh added.