This document, issued by the Central Organisation of ECHS (Ex-Servicemen Contributory Health Scheme), provides a crucial advisory regarding preventive health checkups and Annual Medical Examinations (AME) for its beneficiaries. The primary goal is to clarify the official policy and procedures to ensure proper adherence and avoid misunderstandings.
ЁЯПе Key Points of the Advisory
The advisory is structured into several key points, which provide clear instructions and limitations.
- Reference to Existing Policy: The document refers to an existing government letter (GoI (MoD) letter No. 24(8)/03/US (WE)/D(Res) dated 19 Dec 2003) which outlines the foundational policy for these medical examinations.
- Polyclinic Mandate for AME: It explicitly states that Annual Medical Examinations (AME) can only be conducted at ECHS polyclinics. This is based on the availability of resources at these facilities.
- Restriction on External Referrals: Beneficiaries cannot be referred to an empanelled hospital for an AME. The advisory emphasizes that claims for AME conducted at these external facilities will not be reimbursed. This point is critical for beneficiaries to understand to avoid incurring costs that will not be covered by the scheme.
- Specialist Opinion Clause: A significant point is the provision for obtaining a specialist opinion. If a specialist’s opinion is required for official purposes, it must be sought at a government hospital. The advisory strictly forbids getting this specialist opinion at an empanelled hospital or a service hospital. It clarifies that a referral to an empanelled hospital is only for ailment-based treatment or tests, not for routine examinations or specialist opinions for official purposes.
ЁЯУЭ Implications and Actions
This advisory has several important implications for both beneficiaries and the ECHS administration.
- Beneficiary Compliance: Beneficiaries must strictly follow the guidelines to ensure their medical expenses are covered. Attempting to get an AME or a specialist opinion for official purposes at an unauthorized hospital will result in non-reimbursement. This saves both the beneficiary and the ECHS from unnecessary administrative hassle and financial loss.
- Administrative Directive: The document serves as a clear directive to the Regional Centres of ECHS, instructing them to take necessary action and ensure this policy is communicated effectively. A copy is also marked to the BPA (Billing and Payment Authority) with a specific instruction not to reimburse such claims, reinforcing the policy’s financial implications.
- Authoritative Source: The advisory is signed by (Sri Kant Kumar), Lt Col, Jt Dir (Med) for MD ECHS, which adds an official and authoritative tone to the document, making it a definitive source of information on the matter. You may get the original letter / advisory issued by the uthority in PDF/JPG format as link below.
Download original copy of the letter in PDF/JPEG – Click here.
