REFERRALS

REFERRALS: for Investigations, Specialist treatments, regular admission, etc can be issued: please drop and pick up after some time. This can be done even by email without visiting the Poly Cinic. 
Email: echspolyclinic.panajigoa@gmail.com

 Generation and issue of referral form takes unduly long time.

Poly clinic needs to get even by email:-
1] Specialist approval from MH Panaji, any recent Specialist note if available, from MH Panaji OR any other service Hospital.
2] ECHS Card OR temp slip.
3] Aadhar no.
4] Empaneled hospital Specialists note as available, not compulsory.
5] Mob contact no.
6] Service No. 
7] Postal address.

Waiver is accorded to all veterans suffering from cancer for taking referral / verification by PCs and approval by concerned Specialist / SEMO of Service Hospital for follow up of Chemo / Radio Therapy, valid up to 30 Apr 2020. However tele information has to be given by the veteran to Office In Charge Poly Clinic concerned and JD (HS/Med) at RC ECHS Pune.

Validity period: for routine referral are 01 month: 2 sessions. After one month, fresh referral has to be initiated. However for Cancer cases requiring chemotherapy/radiotherapy, maintenance Haemodialysis, Nephrology, Diabetes, Hypertension and other cardiac patient, it is valid for 06 months. The referral letter should clearly mention the validity period.

Dental referrals will be valid for 60 days (both days inclusive) from the date of issue.

Treatment in Empanelled Hosps on Payment Basis at CGHS Rates on Voluntarily Basis (without referral) cannot be reimbursed. Any resultant prescription for any tests will also not be valid unless approved by PC.

Lasik surgery is considered cosmetic and is not allowed at this stage.

‘Referral’ cannot and will not be demanded by ECHS patient.

Similarly, no demand will be made for any test/process by the beneficiary.

 
REFERRAL TO EMPANELLED HOSPITALS FOR ECHS BENEFICIARIES REQUIRING FOLLOW UP OF CHRONIC AILMENTS IN VIEW OF COVID PANDEMIC like Malignancies requiring Chemotherapy or Radiotherapy, Chronic Kidney Disease requiring Dialysis, Cardiac ailments requiring frequent follow up at Empanelled Hospitals or Treatments requiring frequent intraocular injections.

 Refer:-
(a)  Paras 3 and 6 of CO ECHS letter regarding  Relaxation ECHS policies in view of Covid dated 24 Mar 2020
(b)  Para 6 of Central Org letter issued as Covid Advisory  dated 01 Apr 2020
(c)  Para 3 of Central Org Advisory on Appendices, Referrals and Chemotherapy dated 20 Apr 2020
(d)  Para 2(a) of Central Org Guidelines for Post lockdown w.e.f. 01 Jun 2020 dated 21 May 2020

Healthcare Organisations Empanelled with RC ECHS are requested to treat beneficiaries suffering from Chronic ailments requiring frequent follow up and/or treatment at empanelled hospitals without insisting on a referral from the polyclinic till further orders. All such cases may be treated as emergency and EIR be raised within 96 hours. The Polyclinic and/or RC ECHS may be kept informed about all such cases at the earliest through telephone or mail at all times.

 21 MAY 2020 Central Org Letter

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 CLICK BELOW FOR LATEST ON:-

 SIMPLIFICATION REFERRALS DT 20 MAY 2020

 SEMO & SERVICE SPL APPROVAL BY EMAIL / WHATSAPP DT 30 Apr 2020

 CASHLESS covid-19 TESTS DT 14 MAY 2020
IF CASHLESS FACILITY IS NOT BEING PROVIDED:

See SOP: TREATMENT MANAGEMENT IN ECHS dated 28 Sep 2018
...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)

Same is incorporated in the MoA Signed with every Empanelled Hospital.

All complainants must submit their complaints in writing OR through official email if cashless service is not being provided. RC Pune will have a word with Hospital reps.

TREATMENT IN HOSPITAL HAS TO BE CASHLESS SEE BELOW

 ECHS: SOP FOR ‘ON LINE’ BILL PROCESSING Nov 2017

Oncology Referrals 44.

In order to rationalize Oncology (Onco) referrals, the following procedures will be implemented:-

 (a) All patients reporting initially to ECHS Polyclinic and suspected / confirmed to be suffering from cancer should first be referred to an Oncology Centre of a Service hospital (if available locally) or in the absence of service hospital with Oncology Dept, to an empanelled hospital recognized for oncology where registration, work-up and treatment planning can be carried out.

(b) Patients requiring surgery as part of their multi-modality treatment will be treated in the Service hospital (subject to availability of spare capacity) or the empanelled hospital (recognized for Onco surgery). If facility is not available locally, patient will be referred to the nearest Service hospital/ empanelled facility where such a facility is available.

(c) Patient requiring Chemotherapy/Radiotherapy (RT) will be issued a referral to local Service hospital with Oncology Dept (subject to load) or ECHS empanelled Oncology (Onco) centre once only for the entire duration of treatment.

(d) The stipulation of one month validity for referral forms will not apply for Oncology cases prescribed Chemotherapy/Radiotherapy. The referral form on top should clearly mention “SPECIAL ONCOLOGY REFERRAL” to distinguish it from other referrals.

In case of Dialysis, Cancer (Radiotherapy, Chemotherapy etc), Diabetes, Hypertension & other cardiac patients, the referral will remain valid for 180 days (both days inclusive, No of sessions will also be specified). (Auth: GoI (MoD) letter No 22A(55)/2013/US(WE)/D(Res) dt 05 Jul 2013)


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