As per CGHS requirements, I have to take my FIL to a Govt. Hospital every month for consultation.
Over a period of time, I have come to accept this as de-facto and no longer question CGHS officials about why consultation by Doctor’s at private hospitals (hospitals that are empaneled by CGHS) is not accepted when it comes to prescribing medicines.
While my FIL was at Kolkata, we would take him to S.S.K.M. hospital and to be honest, we had no faith in the ability of doctor’s at that hospital to administer customized care to my critically ill FIL. We had an army of Private doctors who would recommend tests and medicines and we had to use all our ingenuity to persuade the doctor at the Govt. hospital to prescribe what the private doctor had recommended.
This however is not the case back at home. At Hyderabad, we visit the Nizam’s Institute of Medical Sciences (NIMS) and consult with Dr. K. V. Dakshinamurthy; who IMHO is an excellent doctor and a gentleman to boot. He has been very sympathetic and never fails to advice and reassure us w.r.t. the well-being of our patient.
A new issue that we are facing at NIMS is the A.P. Goverment’s Arogyasree scheme that entitles millions of poor citizens of the State of A.P. to avail expensive medical treatment at Govt. Hospitals at the states cost. This has increased the influx of patients at the Govt. hospitals by a quantum leap leaving the generally meager resources at these hospitals stretched to a limit. This has dramatically increased the wait time for CGHS beneficiaries who only want a prescription of medicines but now must compete with the thousands of patients wishing to avail free medical procedures.
This highlights following three lacunae which should be addressed by CGHS:
Secondly, the patient should be able to visit the Govt. Hospital as many times as they want without repeatedly obtaining out-patient referall form. W.r.t. medical prescription, in nay case CGHS Clinics accept only fresh prescriptions generated approximately within 1 month of each other; no frequently.
Thirdly, for patients who are disabled or suffer from critical illness, visiting CGHS Clinic on one day and visiting the Govt. Hospital on yet another day simply exerts enormous strain on them and their family and this is something that is utterly callous on CGHS part. I have encountered at first hand at CGHS where patient suffering from Spinal injury was asked to arrive at the CGHS hospital; even if it meant he would arrive in an ambulance and be carried in a stretcher; thus possibly provoking injuries. Ambulance service in India is neither free nor efficient. If patient is expected to spend an upwards of Rs. 1000/- just to obtain ‘Out-Patient Referral Permission’, it will be considered inhumane by one-and-all.
Only in city like Kolkata do Doctors charge 800 – 2500/- per consultation and thus the only option for many is the practically free Govt. Doctor. Allowing CGHS patients to obtain consultation from private doctors will greatly reduce the load on Govt. Hospitals, many a heart-burn and generally earn brownie points for CGHS.
The poor medical scene in Kolkata is something so horrible, that it is beyond the scope of this article and I will quite possibly write another article about it some day.
These are but a few suggestions which I feel CGHS should implement if it wishes to be categorized as customer centric organisation. Readers of this article are invited to pen their two cents.
26 Responses
Anju
01|Apr|2009 1Hi Rajib,
My mom is a cancer patient in its last stage. she requires, strict follow up checks, frequent investigations, extensive treatment, frequent visits to hospital in emergency/unearthly hrs. very often she is required to undergo immediate tests and investigations. medicines have to be taken round the clock. but as per the CGHS procedure we have to make repeated visits to the dispensary for permission. even though there are relaxation in rule for chronically ill patients but they are not implemented. Its a known fact that a disease like cancer requires multiple lines of treatment (managed by surgery, chemotherapy and radiotherapy) and instead of granting permission for every petty thing,CGHS can simply give one time permission for 3 to 6 months under an umbrella term ” permission for cancer management. this should cover , follow up checks, investigations, and treatment. and beneficiary should be allowed to simply submit a claim especially if the treatment is undergoing in a recognised hospital! intent of the rule should be comfort to the patient and not nurture and promotion of red tapism. so called “life saving drugs” are available from MSD in 10-15 days! there is a provision for chronically ill patients to get medicines indented for 3 months or so. however medicines are never indented beyond a month! most of the times dispensary doesnt have stock for basic drugs like crocin, or shelcal!! and indented medicines are made available only after a gap of 3 days from doctors’s advise. there is an urgent need to simplyfy the procedure. in fact i am personally in favour of decentralization of medical reimbursement claims for pensioners currently kept under abeyance!
D.M. BHATTACHARYYA
27|Jul|2009 2I want to know the names of the private hospitals and nursing homes in Kolkata where I can take admisssion in case of emergency? I am a heart patient and other problems.
D.M. BHATTACHARYYA
27|Jul|2009 3In CGHS Web site the names of ‘BIRLA HEART’ and ‘R.N.TAGORE’ hospitals only available. I want to know whether a CGHS Card holder (Pensioner) can take indoor medical treatment in private hospitals and nursing homes like A.M.R.I/C.M.R.I./KOTHARI/BELLE VUE/WOODLAND. I am having problems of heart, thyroid and respiratory (COPD). Please enlighten me on the matter and and suggest the procedure to get the benefit available , if any. With thanks.
Rajib Ghosh
28|Jul|2009 4Dear D.M. Bhattacharya,
For the most current list of empaneled list of hospitals at Kolkata, you should either visit the CGHS HQ (Esplanade) or the dispensary you are attached to. The list of empaneled hospitals is generally displayed on the notice board quite prominently.
Please note that very few corporate hospitals at Kolkata & Mumbai are actually empaneled due to their charges which are abnormally high.
Belle Vue nursing home for ex: is only empaneled as a diagnostic center and you can avail of their diagnostic services by prior approval from your local dispensary.
Most likely, you will have to either obtain treatment a the few empaneled hospitals or visit a Govt. hospital like SSKM. Also note, you can obtain treatment at a non-empaneled hospital only in the case of emergency. The cost of treatment at non-empaneled hospitals will have to be borne by you and claimed from CGHS later.
HTH
D.M. BHATTACHARYYA
15|Nov|2009 5Dear Rajib Ghosh/any reader,
I am ( a CGHS Card holder pensioner) interested to know the procedure(s) to be observed to get admission to a C.G.H.S. approved private hospitals/nursing homes as indoor patient in Kolkata. In case of emergency wether a CGHS Card holder (Pensioner) can take admission in a govt. or private hospital/nursing home outside Kolkata city, in the Kolkata Metropolitan District (K.M.D.) whose area is spread over, one side from Baruipur( S.24-Prgs) to Tribeni (Hooghly district) and the other side from Barasat (N.24.Prgs) to Uluberia (Howrah district).
With thanks.
Rajib Ghosh
15|Nov|2009 6Dear D.M. Bhattacharya,
In simple terms, in certifiable emergencies, CGHS allows beneficiaries to get admitted and obtain treatment at any hospital across India. In case the patient is admitted to CGHS recognized hospital, the treatment is cashless (upon production of CGHS card in original). In case the patient is admitted to non-CGHS recognised hospital, the treatment is payable by the patient party and can be claimed from CGHS upon discharge.
In non-emergency situations, beneficiaries must obtain prior approval from their local CGHS dispensary.
While pensioners may reside anywhere in India and obtain treatment after registration with the local CGHS dispensary, in-service beneficieries must obtain prior approval from their respective department heads before obtaining treatment at a hospital which is in a different city/town
Hope this helps
D.M. BHATTACHARYYA
15|Nov|2009 7Dear Rajib Ghosh,
Tank you for your kind advice and information. But one thing is not clear to me that in case of emergency, when time does not permit to obtain prior permission/sanction of CGHS office who issued the CGHS Card , what procedure(s) to be followed by the patient or his family members to submit re-imbersent claims for the expenditure(s) incurred f
or treatment in a hospital (govt./Private) anywhere in India and to whom it is to be submitted.
With regards,
Rajib Ghosh
16|Nov|2009 8Dear DM Bhattacharya,
as mentioned in my posts earlier, in case of emergency, you can obtain cashless treatment at any CGHS recognised hospitals anywhere in India.
If admitted to non-CGHS recognised hospital, patient should pay for treatment and claim re-imbursement.
For re-imbursement, please obtain “Medical Reimbursement Claim Form” from your dispensary, fill-it-up as required and submit it at CGHS Head Quarters in your city.
Detail procedures for this are already covered in various articles and comments on this website.
HTH
Hemamalini Ketha
02|Jan|2010 9Dear Reader,
My parents are CGHS card holders and my mother has had a major spine surgery last year. My father is a diabetic and suffers form hypertension related issues. They visit CGHS often for obatining permission for out patient referals.
Recently my mother needed a dental surgery and both went to get permission for the same. They were refered to Usmania General Hospital. But as far as i am aware, UGH doesnt even need specific referals for treatment. When my father requested if she could be refered to a private hospital the “person incharge” was extremely disrespectful and abusive towards my father.
My mother got a catract surgery recently and they went again to get permission for reimbursement. The same “person-incharge” asked my mother to “SIGN AN APOLOGY LETTER”- which he dictated- with out which he refused to sign the permission letter. Under pressure my mother even signed the letter. Now everytime my mother goes to get any work done at his office she is harrassed (waits for hours even though she has a serious back condition) and the “person” threatens that he will use that “APOLOGY LETTER” against her if she complains.
I want to write a detailed complaint letter against this person’s behavior. What is best way to apporach this problem? My mother and father are very hurt by this incident.
I will be very thankful for any suggestions.
Hema
Rajib Ghosh
03|Jan|2010 10Dear Hema,
I am appalled that your parents are being harassed by a Govt. Servant who has clearly forgotten the definition of his job. Perhaps you should remind him that in a few years he will become a CGHS beneficiary too!
I have my share of experiences of really good human beings at CGHS as well as rotten apples. But in general, my policy has been that I am grateful if I am being helped but patient and insistent if I think my rights are being violated. My FIL is a CGHS beneficiary and he has every right to claim service from CGHS when he sacrificed 40 years of his life in working in a poorly paid job in difficult under-developed areas of India.
Apology letter signed if any, have no legal standing (particularly if signed under duress) and the next time this particular Govt. Servant displays the letter, your parents should call his bluff and ask him to go ahead and do what he wants with it.
You can lodge your grievance concerning the functioning of CGHS Staffers either with the CMO of the dispensary or Addl. Director at CGHS HQ in your city (at Begumpet, if you are in Hyderabad).
Currently the exact policy to refer patients to private hospitals for advanced treatment seems to be a gray area. While primary diagnosis must be done at a Govt. Hospital, advanced treatment maybe done at any CGHS recognised Hospital. CGHS Doctors cannot deny this, but they use the cover of 1) rapidly changing CGHS rules 2) No release of CGHS rule change info in public press 3) general pressure from Min. of Health to reduce costs, to deny treatment requests to patients.
You can also either telephone the CGHS helpline or email them if you have specific queries to be answered. They do reply back on email, but you must allow them some time to do so.
HTH
- Rajib
Hemamalini Ketha
03|Jan|2010 11Dear Rajib,
Thank you for your reply. I really appreciate your effort and concerns. I am planning on submitting a detailed grievance letter to the AD of Hyderabad. I found his email and FAX number online.
AS you said, father is a strong believer in the positives of the Indian Govt Health System but there are these “bad apples” everywhere. And by complaining about him atleast i would have taken the effort to improve it at some small level.
Thanks again
Hema
D.M. Bhattacharyya
14|Jan|2010 12Dear Hema,
Sharing your problems I am to say that the CGHS people at your place are not co-operative. But your comments “but there are these ‘ bad apples ‘ everywhere” is not correct. I feel that on account of your parents illness you have been emotionally broken down. In Kolkata (Calcutta) CGHS people are very helpful. Whatever help we require , they always extend. I am a Pensioner CGHS Card holder under treatment for the last eight years. Sister, hope your problems and harassment will cease in course of time .
lalit kumar roy
03|Apr|2010 13Dear Sir, I am a CGHS card holder ( Service ) Card no.S 627199 please arrange to acknowledge about indoor treatment for heart problem in out city kolkata . Did I can pay advance money other then normal patient. Did my office pay for this purpose.
Thanking you,
yours faithfully,
LALITKUMAR ROY
IC-376, Sector-III, Salt Lake,
Kolkata-700 106.
West Bengal
Ujjal Roy
11|Apr|2010 14I am an employee of an autonomus body of Govt. of India. I have no CGHS card. My wife has been treated by a Hospital ( Namely A people’s organization recognized by the Govt. of West Bengal and the Govt. of India. This is not CGHS or our office enlisted Hospital. ) for Pregnancy. Can I claim full reimbursment of my Medicine and other bill.
I will be very thankful for any suggestions.
Ujjal
Barasat
Kol-700124
Rajib Ghosh
11|Apr|2010 15Dear Ujjal,
Since you do not hold a CGHS card, asking CGHS to re-imburse you is out of the question.
The only other authority who can reimburse you is the Govt. Organisation you work for. For this:
- Your office must have a mechanism for reimbursement of medical expenses. Many offices which have tied up with CGHS or ESI etc. do not reimburse expenses unless the treatment was sought with prior approval.
- If your wife was treated on an emergency basis and your office allows for re-imbursement, you may plead your case with the concerned authority.
- Please also be advised that private medical insurance players do not reimburse pregnancy, dental & optical costs outright. The govt. is a little more lenient but may have specific exclusions.
HTH
- Rajib
D.M. Bhattacharyya
01|May|2010 16Dear Rajib Ghosh,
In Kolkata some private Superspciality Hospitals having arrangement of O.P.D. at a very reasonable rate viz. Rs.60/- to 100/-. Will you kindly let me know if I can get medical consultation at those O.P.Ds. under CGHS Rules ? With thanks.
Rajib Ghosh
01|May|2010 17Dear Mr. Bhattacharya,
To the best of my knowledge, CGHS only refers patients to Govt. hospitals for OPD consultation. Private hospitals come into the picture only for super-speciality treatment.
HTH
S.N.SINGH
04|Jul|2010 18Dear Mr. Bhattacharya,
I am a CGHS card holder and I am being harrassed along with my family by CMO incharge of SN-II, L-Block dispensary, Sarojini Nagar, New Delhi-23 by his negative attitute towards me and with my family. Reason is that I am General Secretary of RWA of my colony and as per instruction of Directorate of Health, monthly meeting of RWA member with CMO Incharge was being carried out regularly before joining of this present CMO Incharge but after posting of presently CMO Incharge, he always insisting RWA’s representative to not record any grievences in the monthly meeting. When I opposed for his behaviour he started sending meeting minutes to his authority without obtaining signature of
RWA’s representatives.
On 26-06-2010 I went to this dispensary to collect indended medicines of my family. At the time of indent, a day earlier medicine was indent and very next day it was told to me that one medicine is not permisible.
After collecting remaining medicines, I went to asked CMO Incharge to show me the list of non permissible medicines he refused rudly and snatched one indended medicine from my hand and pushed me outside his room. When I asked him for complaint book he loudly used some unparliament langwages which I can’t mentioned here. After repeated demend he gave me a note book after two hours. I lodged my grievences but same time he through it on the ground and said “JO UKHARNA HO UKHAR LENA”. I don’t believe that a govt. employee can behaived with public in this manner. I am very hurt by this incident.
Please tell me, Can I shift my dispensary to nearby locality or the said CMO Incharge could be transferred to other place?
D.M. BHATTACHARYYA (HOWRAH)
21|Jul|2010 19Dear Mr. S.N. Singh,
I have gone through your insertion again and again. Brother, it was a time decades ago when ‘Doctors and Teachers’ were very respectable persons in the society for their dedicated service to the society. Now-a-days we are to forget this. Your attending CGHS doctor has, most probably, forgotten that the government had to incur eight to ten lakhs rupees from public exchequer (tax payer’s fund)
D.M. BHATTACHARYYA (HOWRAH)
21|Jul|2010 20Dear Mr. S.N. Singh,
In continuation of mt earlier comments I would suggest that you should bring the matter to the notice of the Director, CGHS, New Delhi. All correspondence should be sent under registered post with Ack.due. In Kolkata (Calcutta) we cannot imagine this happenings. I share your sentiments. Further, I would tell you to put up your grievences and seek advice for redressal from Mr. Rajib Ghosh who is an expert in CGHS matters.
santanu das
03|Aug|2010 21give me the list through e-mail name of ployclinc /hospital at hooghly dist.
Rajib Ghosh
04|Aug|2010 22Dear Santanu,
Check this site, it may have information that you are looking for:
http://cghskolkata.nic.in/html/list_disp.htm
http://www.imyideas.com/2010/07/updated-list-of-cghs-hospitals-in.html
D.M. BHATTACHARYYA (HOWRAH)
09|Aug|2010 23Dear Santanu,
So far I know, there is no CGHS Dispensary or Policlinic in Hooghly district. Of course, there is no bar to receive medical treatment under CGHS Rules in respect of working/retired Central Govt. CGHS Card holder employees residing in Hooghly District
D.M. BHATTACHARYYA (HOWRAH)
15|Oct|2010 24Dear Rajib Ghosh,
Recently I took admission in BP PODDAR Hospital Kolkata (a multi-speciality private hospital for investigations and treatment. Kolkata CGHS Doctors helped me a lot. CGHS People in Kolkata are very helpful, whereas Mr.S.N. Singh of Kanpur speaks otherwise as regardsCGHS counterpart working , I am sorry for him.
s.chakraborty
16|Nov|2010 25Dear sir,
am a copd patient..frequently suffering from lungs problems would lyk to know the names of the best doctors concernd in kolkata if its possible for proper treatment
manish sachdeva
05|Apr|2011 26my mother is admitted in city hospital jabalpur. for further treaement , she has been reffered to lucknow, may i know best hospitals of lucknow giving cghs facility .
does cghs gives ambulance facility or transfer conveyence to patient and family members with doctor, nurse-+ -et-c.
to
go to lucknow.
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