EMERGENCY OPTIONS:-
1]
a) Report to nearest service hospital for treatment.
b) Report to nearest empanelled hospital.
c) Report to nearest non-emp hospital. ESM/his representative will have to pay the charges to the non emp hospital initially.
Emergency Intimation Referral has to be raised by Hospital within 48 hrs, EVEN BY EMAIL.
2]
a] What is the procedure for an emergency treatment ?
a] What is the procedure for an emergency treatment ?
Ans. (i) Preferably report to a service hospital/empanelled facility.
(ii) Prove identity through ECHS Smart Card/ Acknowledgment Slip.
(iii) Empanelled Hospital will inform ECHS polyclinic at the earliest (but not later than 48 hrs) with the following details:
ECHS membership, Service No, Rank & Name of the ECHS member, Diagnosis, Date and time of admission, Hospital to which admitted.
ECHS membership, Service No, Rank & Name of the ECHS member, Diagnosis, Date and time of admission, Hospital to which admitted.
(iv) OIC polyclinic will make arrangements for verification of the facts.
b] Comprehensive care (services of many professionals working together) of the patient is the responsibility of the hospital.
f] MH Panaji dies not have facility for comfort care, as no continuous oxygen supply is available (oxygen cylinders are being used). Such cases should continue in the same hospital or take home.
b] Comprehensive care (services of many professionals working together) of the patient is the responsibility of the hospital.
c] For emergency cases, whatever is needed has to be done, patient should not suffer. Emergency procedure cannot be delayed for want of approval of Service Specialist, which is not needed at all. Treatment should be logical, continuous approvals not needed.
d] For non-emergency, approval is needed, with proper justification which takes time as Service Senior advisor has to be contacted at Pune and more details of the patient are needed.
e] MORE HERE:-
In emergencies, the hospital may proceed with the treatment / test / procedure and justify the case in discharge summary.
(ECHS Central Org letter dt 03 Feb 2017, see para 3 and Notes points 1 and 3)
g] CLICK BELOW LINK FOR FLOW CHART
EMERGENCY CASE IN EMPANELED HOSPITAL
3]
What is the procedure for an emergency treatment at a non empanelled hospital?
What is the procedure for an emergency treatment at a non empanelled hospital?
Ans. (a) Inform nearest ECHS polyclinic within 48 hours.
(b) Bills will be cleared by the beneficiary.
(c) Member submits bill along with summary of the case to the concerned polyclinic within 90 Days from the date of discharge from hospital for reimbursement.
(d) Sanction of reimbursement will be accorded at various Competant Financial Authority levels at CGHS rates.
(e) Payment to be made by station HQ.
CLICK BELOW LINK FOR FLOW CHART
EMERGENCY CASE IN NON EMPANELED HOSPITAL
CLICK BELOW LINK FOR FLOW CHART
EMERGENCY CASE IN NON EMPANELED HOSPITAL
4]
Duration of Hospitalisation.
Duration of Hospitalisation.
(a) Duration of hospitalisation for various ailments is broadly as under though it
will depend on case to case basis:-
(i) Specialised procedures - 12 days.
(ii) Other major procedures - 07- 08 days.
(iii) Laparoscopic surgery - 03 days.
(iv) Day care/minor procedures - 01 day.
(b) The hospitals must focus on active treatment and admission duration should not be unduly extended only for generating unnecessary bills. Only minimum & essential duration should be used. The current duration for sanction is as under (no sanction required upto 12 days but it does not mean that patients have to be admitted for 12 days):-
(i) Officer In Charge Polyclinic - 13 to 30 days.
(ii) Dirercot Regional Centre - 31 to 60 days.
(iii) Managing Director ECHS - Above 60 days upto 120 days.
(ii) Dirercot Regional Centre - 31 to 60 days.
(iii) Managing Director ECHS - Above 60 days upto 120 days.
5]
Issue of Medicines. Empanelled hosps will issue medicines upto seven days subject to value not being more than Rs 2000/- after patient is discharged in IPD (hospitalised) cases (Normal as well as emergency cases). Medicines beyond this will be issued by PolyClinics. Hosps will write generic medicines.
....44 (p)
When a patient is referred to an empanelled hosp for any treatment, it must be done in totality, for example, if a patient has been referred to an empanelled hospital, consultation, all investigations and surgical procedures will be done by the empanelled hosp.
Package cost includes treatment/procedure including admission charges, accommodation charges, ICU/ICCU charges, monitoring charges, operation theatre charges, operation charges, anesthetic charges, procedural charges/Surgion fee, cost of disposables, surgical charges and cost of medicines used during hospitalization, related routine investigations, physiotherapy charges etc. and
the package rate does not include diet, telephone charges, TV charges and cost of cosmetics, toiletry and tonics. (Auth : Para 4(b)(iv)(v) of MoD (GoI) letter No 24(8)/03/US(WE)/D(res) dt 19 Dec 2003).
It has been seen that some of the empanelled hosps send back ECHS patients for lab/ diagnostic test from PolyClinic/ service hosp/ other hosps which is strictly prohibited. In case of all IPD (hospitalised) cases also, if a particular test is NA in the referred hosp, same will be organized by empanelled hosp and ECHS will be billed as per CGHS rates. If such a test happens to be ‘unlisted’, sanction will be obtained by the empanelled hospital.
8]
9]
UNLISTED PROCEDURES / TESTS / IMPLANTS APPROVALS CLICK FOR CIRCULARS DATED
10]
CGHS Rates 2020
Issue of Medicines. Empanelled hosps will issue medicines upto seven days subject to value not being more than Rs 2000/- after patient is discharged in IPD (hospitalised) cases (Normal as well as emergency cases). Medicines beyond this will be issued by PolyClinics. Hosps will write generic medicines.
6]
One free consultation within 15 days is provided post discharge by empaneled hospital Goa... check before discharge from Hosp.
7]
CASHLESS FACILITY:
CASHLESS FACILITY:
See SOP: TREATMENT MANAGEMENT IN ECHS dated 28 Sep 2018: link below
...44. Referral based Treatment....(h)
No Cheque/ Cash/ Payment will be taken from ECHS patients under any Circumstances except when the patient opts for higher value implant than the ceiling limit for which written consent will be obtained. No payment for disposal etc is allowed to be charged. (Auth : Para 4(b)(x) of GoI (MoD) letter No 24(8)/03/US(WE)/D(Res) dt 19 Dec 2003)
No Cheque/ Cash/ Payment will be taken from ECHS patients under any Circumstances except when the patient opts for higher value implant than the ceiling limit for which written consent will be obtained. No payment for disposal etc is allowed to be charged. (Auth : Para 4(b)(x) of GoI (MoD) letter No 24(8)/03/US(WE)/D(Res) dt 19 Dec 2003)
Same is incorporated in the MoA Signed with every Empanelled Hospital.
....44 (p)
When a patient is referred to an empanelled hosp for any treatment, it must be done in totality, for example, if a patient has been referred to an empanelled hospital, consultation, all investigations and surgical procedures will be done by the empanelled hosp.
Package cost includes treatment/procedure including admission charges, accommodation charges, ICU/ICCU charges, monitoring charges, operation theatre charges, operation charges, anesthetic charges, procedural charges/Surgion fee, cost of disposables, surgical charges and cost of medicines used during hospitalization, related routine investigations, physiotherapy charges etc. and
the package rate does not include diet, telephone charges, TV charges and cost of cosmetics, toiletry and tonics. (Auth : Para 4(b)(iv)(v) of MoD (GoI) letter No 24(8)/03/US(WE)/D(res) dt 19 Dec 2003).
It has been seen that some of the empanelled hosps send back ECHS patients for lab/ diagnostic test from PolyClinic/ service hosp/ other hosps which is strictly prohibited. In case of all IPD (hospitalised) cases also, if a particular test is NA in the referred hosp, same will be organized by empanelled hosp and ECHS will be billed as per CGHS rates. If such a test happens to be ‘unlisted’, sanction will be obtained by the empanelled hospital.
8]
All complainants must submit their complaints and / or unwarranted paid bills in writing OR through official email if cashless service is not being provided for onward submission to Regional Center Pune.
UNLISTED PROCEDURES / TESTS / IMPLANTS APPROVALS CLICK FOR CIRCULARS DATED
a] 30 Apr 2020
b] 03 Feb 2017
b] 03 Feb 2017
c] 28 Jun 2011
10]
CGHS Rates 2020
11]
Concerning the end of life situation, when it is clear that death is imminent and inevitable, no matter what medical procedures are attempted, one may refuse treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted.”
"Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected."
Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable. Palliative care is a special form of disinterested charity. As such it should be encouraged.
CLICK BELOW LINKS TO GO TO:-
ECHS Polyclinic Panaji 8 am to 4 pm on working days:
Phones: 0832 2420829
9552584587
Email: echspolyclinic.panajigoa@gmail.com
Military Hospital Panaji Phones:
0832 2226246-49
7030922784
DISCLAIMER: Please refer official letters, SOP, etc. These are just guidelines.
