So far, 4 lakh employees / pensioners have been enrolled and issued e-Cards under the Cashless Health Insurance Scheme for employees and pensioners started by Punjab Government from 1st January 2016. This was stated here today by Principal Secretary Health, Ms Vini Mahajan. She said it is for the very first time in India, the employees have been issued Mobile e-Cards and any employee can download on his/her mobile the special App "PGEPHIS" and can look into the details of the scheme, empanelled hospitals, pharmacies, claim status, and authorization status etc. Every employee/pensioner has been informed through SMS regarding confirmation of his/her enrollment and the link for this Application. This is the unique feature that empowers every employee/pensioner to have correct and complete status of his/her claim on his/her finger tips, added Ms Mahajan. She stated that so far, 341 private hospitals all over the State are providing services under this scheme and their details are available on website www.pbhealth.gov.in.
This includes 212 multi-specialty hospitals and 129 single specialty hospitals. Many state-of-the-art hospitals like Medanta Gurgaon, Metro chain of hospitals Delhi, Fortis Hospital, MAX Bathinda, IVY Hospital Mohali, Gracian Hospital Mohali, Mayo Hospital Mohali, Grewal Eye Hospital Chandigarh etc. are part of this scheme. She stated that the Insurance Company has already processed cashless claims to the tune of Rs. 2.80 crore for treatment given to 1054 employees / pensioners. In case of any clarification, the beneficiaries can call toll free medical helpline number 104 or can contact 1800-233-4411 or can email to [email protected].
Hussan Lal, Secretary Health cum Managing Director PHSC added that owing to certain reports in a section of press regarding some difficulties being faced by employees, he convened a meeting with the employees union recently in which Ranvir Dhillon, Sh. Sajjan Singh participated and contrary to the reports, they were quite appreciative about the scheme. Though some concerns regarding chronic disease reimbursement were flagged by the employees leaders, it was assured that that chain of pharmacies are being empanelled to dispense cashless medicines to the chronic disease patients but till the registration of chronic disease patients is complete and the empanelment is in place, the employees would be getting reimbursement of their bills from the Insurance Company on the existing pattern.
He revealed that there was some confusion regarding interpretation of the notified rates by the Private Hospitals. When clarified, the hospitals are finding these rates to be much more reasonable/ viable as compared to other schemes. He further informed that Fortis Mohali which is the only International level JCI accredited hospital in the northern region now stands empanelled and has agreed to provide cashless treatment to Punjab Government employees and pensioners. Rather 25 employees have already taken cashless treatment from the Fortis, Mohali under this tie up. He also, clarified that since AIIMS Delhi, PGIMER, GMCH Sector 32, and other big Government hospitals don't have dedicated manpower for the scheme to carry cashless transactions, so bills of such Government hospitals will be reimbursed to the employees and pensioners by the Insurance Company for the time being. State Government will also be organizing a workshop in Chandigarh this month for clarifying the doubts and training regarding obtaining prompt authorization from the Insurance Company so that the overall system could be strengthened and certain initial roadblocks like authorization and approvals be removed.