EMERGENCY TREATMENT IN CGHS HOSPITALS
CGHS Hospitals – Getting treatment in
emergency conditions
Under emergency conditions, the empanelled hospitals are expected to provide
treatment of CGHS beneficiaries in all available specialties…
Private hospitals have been empanelled under CGHS only for
such specialties for which they are eligible as per the terms and
conditions of empanelment. However under emergency conditions, the empanelled
hospitals are expected to provide treatment of CGHS beneficiaries in all
available specialties.
“Emergency” shall mean any condition or symptom resulting from any cause,
arising suddenly and if not treated at the earliest opportunity would be
detrimental to the health of the patient or shall jeopardize the life of the
patient".
CGHS beneficiary attending hospital in emergency: In such
a situation the Hospital shall intimate to BCA within 2 hours of admission and
BCA shall respond in 4 hours (however treatment shall not be denied to any CGHS
member and this is only an initiation of the e-workflow). Post discharge
hospital would upload bills and download documents as per requirements of CGHS
within 72 hours.
TREATMENT IN EMERGENCY
In emergency the hospital shall not refuse admission or
demand an advance payment from the beneficiary or his family member and shall
provide credit facilities to the patient whether the patient is a serving
employee or a pensioner availing CGHS facilities, on production of a valid CGHS
card and the hospital shall submit the bill for reimbursement to the concerned
Deptt. / Ministry / CGHS. The refusal to provide the treatment to
bonafide CGHS beneficiaries in emergency cases without valid ground would
attract disqualification for continuation of empanelment.
The following ailments may be treated as emergency which
is illustrative only and not exhaustive, depending on the condition of
the patient :
Acute Coronary Syndromes (Coronary Artery Bye-pass Graft /
Percutaneous, Transluminal Coronary Angioplasty) including Myocardial
Infarction, Unstable Angina, Ventricular Arrhythmias, Paroxysmal
Supra Ventricular Tachycardia, Cardiac Temponade, Acute Left Ventricular
Failure / Severe Congestive Cardiac Failure, Accelerated Hypertension, Complete
Heart Block and Stoke Adam attack, Acute Aortic Dissection.
Acute Limb Ischemia, Rupture
of Aneurysm, Medical and Surgical shock and peripheral circulatory
failure. Cerebro-Vascular attack-Stokes, Sudden unconsciousness, Head
injury, Respiratory failure, decompensated lung disease, Cerebro-Meningeal
Infections, Convulsions, Acute Paralysis, Acute Visual loss.
Acute Abdomen pain.
Road Traffic Accidents / with
injuries including fall. Severe
Hemorrhage due to any cause.
Acute poisoning.
Acute Renal Failure.
Acute abdomen pain in female
including acute Obstetrical and Gynecological emergencies.
Electric shock.
Any other life threatening
condition.
Source: CGEN.in
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