The Rajasthan government on Friday said that interventions by the state health department resulted in hospitals refunding claim amounts to the tune of Rs 36 lakh charged from patients insured under its flagship health scheme – Mukhyamantri Chiranjeevi Swasthya Bima Yojna – launched almost three months ago. As per the official sources, hospitals refunded the claim amount in 267 cases, which summed up to around Rs 36 lakh, after intervention by the state health department.
“More than 1.6 lakh people have already availed cashless treatment under the MM Chiranjeevi Swasthya Bima Yojna, however, in few cases the patients were unduly charged by some hospitals. We are analyzing the complaints and initiating refunds wherever necessary,” said Aruna Rajoria, CEO, State Health Assurance Agency, Rajasthan government.
Launched on May 1 this year, the health scheme has over 1.3 crore people (80 percent of the state population) registered as beneficiaries. The scheme offers cashless annual insurance cover of up to Rs 5 lakh for all citizens of Rajasthan for a premium of Rs 850 per family, while registration under the scheme is free for families included in the National Food Security Act, Socioeconomic Caste Census 2011 beneficiaries, Covid-19 ex-gratia list, contractual workers and small and marginal farmers.
The Mukhyamantri Chiranjeevi Swasthya Bima Yojna has empanelled more than 450 private and 756 public hospitals to extend the services to the entire population of the state.
Rajoria said since the scheme was new, many hospitals were unaware of its provisions. “Also, mucormycosis emerged as a major threat in the middle of the second COVID wave and was subsequently added to the list of permitted procedures. This confusion resulted in several of the insured patients being unduly charged by some hospitals,” she said.
To avoid such situations in future, the state health department has established a 24×7 call centre to answer every complaint. It has also appointed consultants at the empanelled hospitals to help the beneficiaries and make them choose the right treatment option.
Moreover, nodal officers have also been assigned to every zone to ensure every complaint gets resolved and registered beneficiaries receive their due benefits in empanelled hospitals.
Officials said that Chief Minister Ashok Gehlot has directed the officials to conduct door-to-door surveys for linking all eligible families to the Mukhyamantri Chiranjeevi Swasthya Bima Yojna. He also asked them to associate more private hospitals having good health facilities and infrastructure across the state with the scheme so that a large number of beneficiaries can take advantage of the scheme.