Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly. This procedure is done frequently as a life saving measures for the patient suffering from renal failure (CKD-V stage).
Government of West Bengal
Finance Department
Medical Cell, Writers’ Building
No. 197-F(MED)WB Dated- 23/11/2022
Sub:- Process flow to reimburse Dialysis charges for CKD (stage-V) patient through WBHS Portal.
Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly. This procedure is done frequently as a life saving measures for the patient suffering from renal failure (CKD-V stage).
Dialysis is done either IPD or Day Care (OPD) mode in all hospitals. Owing to frequent occurrence (2 or 3 times in a week), patient generally chooses nearby hospital for undergoing such procedure.
In case of online claim processing through WBHS Portal, enrolled beneficiary as well as government offices are at present, facing some problem while processing claim of such dialysis charges. Beneficiary suffering from renal failure (CKD-V stage) avails dialysis in the following two types of hospitals:-
A. In recognized/ empanelled/ enlisted hospital where dialysis is provided as IPD or Day Care (OPD) treatment by issuing Discharge Summary and/or Dialysis Chart.
B. In non-empanelled hospital where dialysis is provided as IPD treatment by issuing Discharge Summary and/or Dialysis Chart.
Process flows of claiming and disposing reimbursement claim in the WBHS Portal for both the above two cases are given below:
A. When treating hospital is recognized/ empanelled/ enlisted one and dialysis is provided as IPD or Day Care (OPD) treatment by issuing Discharge Summary and/or Dialysis Chart.
B. When treating hospital is non-empanelled one and dialysis is provided as IPD treatment by issuing Discharge Summary and Dialysis Chart.
This process flow shall not be applicable for any other category of treatment and claim thereof under WBHS.
Sri Aloke Kumar Mukherjee, WBA & AS
Joint Secretary, Finance Department
Government of West Bengal