echs non empanelled hospital bill

ECHS Rules on Medical Bill for Admission to Non Empaneled Hospitals : Govt Orders

Govt has allowed to avail the treatment from empaneled and non empaneled hospital both. But the beneficiaries are facing several issues regarding bill payment and other terms as described here :-

(a) Rate of treatment cost to be paid at Non NABH CGHS but Hospitals demand Pvt rate as fixed by them which has no control and depend on the quality of the Hospital.

(b) Beneficiaries are not getting reimbursement even though 50% of the total cost of treatment. Which defeat the very purpose of ECHS membership.

(c) Non empaneled Hospitals shows ignoring behaviour for the ECHS/CGHS beneficiaries.

A letter issued by the CO ECHS is reproduced here in this regard.

Tele: 25683476 Mil: 36833









B/49774/AG/ECHS/Referral/2023




(_________________________________________ ) All Regional Centres
Central Organisation, ECHS
Adjutant General’s Branch
Integrated Headquarters
Ministry of Defence (Army)
Thimayya Marg, Near
Gopinath Circle
Delhi Cantt-110010     

        22 Sep 2023


ADVISORY FOR TREATMENT AT NON EMPANELLED HOSPITAL

1           Please refer to following:-

Para 16 & 18 (a) of SOP on Treatment Management dated 28 Sep 2018.
CO ECHS Letter No. B/49770/AG/ECHS dated 05 Oct 2018.
CO ECHS letter No. B/49770/AG/ECHS/Prior/Policy/2023 dated 08 Feb 2023.

It is intimated that treatment at Non Emp Hospital is allowed only under emergency conditions as per para 16 of SOP on Treatment Management dated 28 Sep 2018. If any veteran desires to take treatment in non emp hospital as per Para 18 (a) of SOP on Treatment Management dated 28 Sep 2018 he may do so after permission of MD ECHS/Dir RC ECHS.

It is observed that there is increasing tendency of ECHS beneficiaries resorting to treatment at Non Emp Hosp at their own will without prior sanction which is against the laid down ECHS guidelines and interest of ECHS beneficiaries at large. Non empanelled hospitals have tendency of inflating the bills. The bills are reimbursed for genuine emergencies only but at Non NABH CGHS rates only.

If beneficiary is planning treatment at non empanelled hospital for any planned
treatment then prior sanction from concerned Regional Centre is mandatory. There are few categories of ailments for which permission from CO ECHS is required and some cases may involve unlisted implants, procedure or investigation requiring SEMO’s permission.

         Treatment at non empanelled hosp, without prior approval in case of non-emergency, should invariably be avoided by beneficiaries. OIC and MOs at PC may please be advised to spread this awareness amongst beneficiaries

For your info and strict compliance please.

Col
Dir (Med)
For MD ECHS

Internal
Claim Sec
Stats & Automation Sec                                   for uploading the letter on ECHS website.

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