Relief for patients as pvt hosps withhold suspension of cashless treatment under RGHS
Earlier, RAHA called for stopping cashless treatment from July 15 under RGHS, protesting non-payment of bills for seven months along with other demands related to RGHS.
"We will continue to provide cashless treatment to the RGHS beneficiaries as we were doing earlier. We have taken this decision after cordial discussions with the health department officials today (Monday)," Major General Dr SC Pareek, convenor of the eight-member advisory committee of RAHA, told TOI.
He said, "We had some issues related to pending payments, closure of the transaction management system (TMS) of hospitals, and treatment protocols. We also demanded our participation in the formulation of the future standard operating procedures regarding RGHS implementation. They (govt) have agreed to it. It was a cordial discussion for a sustainable solution benefiting patients and hospitals."
A senior health department official said, "The meeting was held on a positive note to ensure patients continue getting cashless treatment under the RGHS scheme."
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One of the demands of the RAHA was the unblocking of TMS portals, by immediate reinstatement of TMS access for claims closed on minor technical grounds, allowing hospitals to resubmit or amend such cases. On this demand, the health department assured the RAHA committee to unblock the TMS access, and proceedings will be expedited following due process as mentioned in the scheme guidelines.
Regarding the demand for pending bills, the health department said that a major portion of outstanding approved claims was released.
RGHS will expedite further payments and try to clear remaining outstanding claims by March 31, 2025, by July 31, 2025. On the demand for timely payment of hospital bills against cashless treatment of patients under RGHS, the health department pointed out that RGHS strives to maintain a 45 to 60-day payment cycle subject to budget constraints, and efforts are being made to align the timeline with the standard settlement process.
On the demand for the participation of RAHA in the formulation of SOPs, the health department said that the minimum document protocol (MDP) for various components is in the process of formulation. The various stakeholders, including the advisory committee (RAHA), will be consulted and will try to finalise within three months, adding that RGHS acknowledges the role of consultation and will have regular dialogue with the identified representatives of various stakeholders, including the empanelled private hospitals and pharmacies.
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