Bhubaneswar, 1st Aug
In another step towards ease of hassle-free treatment for the ABPMJAY-GJAY card holders and road accident victims under PM-RAHAT scheme, State Government through State Health Assurance Society ( SHAS) organised intensive orientation camp for the empanelled hospitals. Around 779 empanelled private hospitals from all 30 districts of Odisha arranged in different batches were imparted in-depth training on different dimensions of these schemes over a week-long camp concluded here last evening.
Addressing the representatives from empanelled hospitals on the opening day, Dr Brundha D. Chief Executive officer of SHAS urged them to ensure cashless and hassle-free treatment of the patients with ABPMJAY-GJAY and AVVY cards. She also directed to prioritize free treatment of the road accidents victims under Pradhan Mantri Road Accident Victim Hospitalization and Assured Treatment ( PM-RAHAT) as per Government guidelines circulated to all the hospitals. Dr Brundha, added, people’s happiness over the schemes are directly proportional to the type of dealing and quality of treatment they receive at the hospitals. People come to the hospitals with the hope of getting relief and cure form disease. Central and State Government have made all necessary normative and financial provisions for their cashless treatment. Government bears the cost of their treatment. So, the empanelled hospitals should always be vigilant to receive, admit and provide quality treatment. The hospitals were warned that any negligence, corruptive action or dillydallying would be seriously viewed by Government.
Training was imparted on different topics like coverage of pre and post hospitalization expenses (pathological tests, other investigations and post hospitalisation check-up), turn-around time ( TAT) for registration of the patients, pre-authorization, resolution on grievances through online portal and claim adjudication. It was made clear to them that all pre-authorization requests under specified packages, if properly put on the portal would be approved within minutes and hours. Maximum TAT for such request is 6 hours after which it would be deemed to be approved. They were also clarified about the time period to reply queries on pre-auth requests. The duties and responsibilities of Medcos in the process of pre-auth submission and claim raising were elaborately discussed. The themes like raising of appropriate claims, maintaining dignity and privacy of the patients were clearly explained by the trainers and doubts were clarified on the floor through elaborate discussion.
The guidelines and modus operandi under PM-RAHAT scheme were also discussed in detail. it was made clear that all hospitals must provide cashless treatment to all motor vehicle accident victims brought to hospitals within 24 hours of the accident. Each victim is entitled to get free treatment of Rs.1.5 lakh up to seven days of the accident. The procedures for raising claims under PM-RAHAT, display of banners and posters in the hospital about the scheme were also explained in detail.
The hospitals were asked to integrate their hospital management system with Ayushman Bharat Digital Mission (ABDM) platform for seamless digital healthcare service. Such integration would improve patient care, reduce the burden of physical record keeping, facilitate exchange of information among hospitals in case of referral of patients, help efficient claim processing and make the hospitals future-ready for digital health care.
Additional Secretary and Joint CEO SHAS Sri Ratnakara Sahoo, Additional Director Dr Bishnu Prasad Mohapatra, Dr Rashmi Ranjan Satpathy, Dr Subhrajit Rao, Dr Arun Mohapatra imparted training as resource persons.
