Thursday, August 28, 2008

ECHS: CFA for Medical Expenses


PROCEDURE FOR PAYMENT AND REIMBURSEMENT OF MEDICAL EXPENSES UNDER ECHS

1. Reference GOI, MoD letter No. 24(8)/03/US(WE)/D(Res) dt 19 Dec 2003 and this HQ letter No. B/49778/AG/ECHS/Policy dt 16 May 2007.
2. Presently, all individual medical bills are being processed through this HQ. It has been decided that the time taken for processing of these bills needs to be reduced without compromising on the efficiency of scrutiny.
3. Over five years of experience, the following problems have been noticed in the above procedure. The procedure is time consuming:
  • Virtually no valuable addition after SEMO/Stn HQ level.
  • Avoidable paper work and addl effort.
  • Results in dissatisfaction amongst the veterans.

    In order to overcome the above difficulties and based on the directions of Secy(ESW), the authority is delegated to lower HQ since there is no loss to the State. Therefore, the individual medical claims will also be processed and sanctioned like claims for reimbursement to empanelled hospitals, by the appropriate CFA.

    Diagrammatic representation of the revised system is as per Appx A shown above. For bills below Rs 2 Lakh, Regional Centres have been kept out of this loop to save time. This procedure will be implemented with immediate effect. Bills already despatched to Regional Centre/ Central Org, ECHS will be processed as done hithertofore.

    Sanction by the CFA on behalf of Central Org, ECHS will be granted. A sample of the sanction is attached as Appx B shown below the letter. Necessary amendments to Govt letter will be carried out after the overall review of ECHS.

    Sd/-
    (KJS Makker)
    Wg Cdr
    Offg Dir(Med)
    For Managing Director

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