September 14, 2011 at 3:29 pm #55424
As per Rule 14.1 of Agreement of West Bengal Health Scheme 2008, "All bills and papers related to the beneficiaries treatment shall be handed over in original along with the necessary counter signatures by the authorised persons."
As per Rule 15.1, "If any dispute or difference of any kind whatsoever (the decision whereof is not herein otherwise provided for) shall arise between the Authority of the WBHS 2008 and the Hospital/ Diagnostic Centre upon or in relation to or in connection with or arising out of the Agreement, shall be referred to for arbitration by the Director of Medical Education, West Bengal, who shall give written award of his decision to the Parties. The decision of the Director of Medical Education, West Bengal shall be final and binding. The provisions of the Arbitration and Conciliation Act, 1996 (26 of 1996) shall apply to the arbitration proceedings. The venue of the arbitration proceedings shall be at Kolkata."
So just start a discussion with the Hospital authority that you are going to act as per the said rule and going to take legal action. Always keep received copy of your application as a proof.
By the by, you may also contact Medical Cell at Writer’s Buildings for necessary guidance in this regard. Enter Writer’s Buildings through Gate No. 1, and then at the Ground Floor you can find ‘Medical Cell’.September 23, 2011 at 12:20 am #55425
He is not entitled to get the cost of follow up medicine for heart disease except cardiac surgery.
Cost of one time treatment in OPD should be reimbursed. Indoor/ OPD treatment must be mentioned in Form – D by the treating Specialist. In case of Indoor treatment counter signature of Medical Superintendent is essential. Necessary declaration by the Pensioner in Form – C is sufficient. In case of Indoor treatment the pensioner claimed 11300/- as Coronary Angiography (1 day's package). As per revised rate list the new rate for the item will be 11700/-. No other charges as claimed by the pensioner is admissible. Because approved package rate is inclusive of all other charges (18 nos.) as mentioned in the Scheme. He may thus be granted Rs. 11300/- only.November 29, 2011 at 3:49 pm #55426
7: this facility is effective from the month in which medical allowance is deducted from your pay.December 3, 2011 at 12:32 pm #55427
9: In case of Indoor treatment at enlisted Health Care Organisations (H.C.O.) don't bother about package. Total claim will be reimbursed upon scrutiny from respective authority. If any objection arise regarding the admissibility of the disease, then, let it be clarified by the H.C.O.January 1, 2012 at 12:41 am #55428
11: No. You will get full on major and up to 80% on minor procedures, which depends on bed capacity of the H.C.O. It may possibly be 60% for Susrut Eye Foundation.January 28, 2012 at 7:09 pm #55429
Is the cost of health checkup reimbursed. This has been advised @ the OPD of Apollo Gleneagles as well as RNTIICSJanuary 30, 2012 at 9:04 pm #55430
if prior to entry into WBHS’2008, a member was having treatment at Jaslok Hospital, Mumbai under Economy category patient, will he be allowed to continue the same treatment at the said hospital & reimbursedJanuary 31, 2012 at 9:29 pm #55431
reimbursement for follow up treatment is defined for particular diseases.January 31, 2012 at 9:32 pm #55432
there is a list for OPD treatment which can be reimbursed. download sl no 30 for the list.February 11, 2012 at 8:22 pm #55433
Sir, please provide me a list of Enlisted ( Class-I & Class-II )Private Hospitals under WBHS-2008 with effect from 01-01-2012February 11, 2012 at 8:43 pm #55434February 21, 2012 at 10:06 pm #55435
I am to join foreign service (a corporation substantially financed by govt) on deputation. Can I claim outstanding 50% of the 3rd instalment before getting release from the govt office?February 23, 2012 at 11:08 pm #55436
currently i am working as assistant teacher in a govt aided school , recruited by wbssc , am i eligible for west bengal health scheme. if yes then how do i enrolled. if not then, is there any govt medical facility for us.February 26, 2012 at 6:59 pm #55437
Dr has provided with an estimate of Rs100000 for ventral hernia repair, including disposal amounting to Rs57000. will u inform me about the amount reimbursable?March 3, 2012 at 8:33 am #55438
Medical advance was sanctioned in my favour under WBHS 2008. But now, how should I refund the excess amount according to Govt. norms. Please guide me immediately. Thanking you,March 8, 2012 at 11:56 am #55439
a patient having nerve problem has been submitting bills for OPD treatment on monthly basis. is he allowed to get it be reimbursed all the bills or allowed only for the first one?pl advice.March 10, 2012 at 4:18 pm #55440
I am a state government employee posted in Purulia have a grievance regarding West Bengal Health Scheme 2008. Sir, I am covered by the West Bengal Health Scheme 2008. I need to regularly do medical check-ups of my wife in different empanelled private hospitals under the scheme. I have received reimbursements for such OPD check-ups before as well.
But, on the last occasion an objection was given on my reimbursement form by Purulia’s Treasury Officer and it was again put on stand the second time, even after I sent all the requisite documents and orders. The objection was given as : OPD Treatment should not be allowed as per order no. 10539 F[MED] dated 21/11/11 finance department by the Treasury Officer, Mr. Madhu Sudan Naskar.
But the said order is for non-empanelled hospitals only. But I did my wife’s check-up in Desun Hospital, Kolkata which is an empanelled hospital under West Bengal Health Scheme 2008. Desun Hospital’s empanelled code is: 0411001.
Thus, I am eligible for reimbursement as Desun Hospital is an empanelled hospital. Further Sir, the following link of the Order No 10539-F[MED] dated 21/11/11 gives a clear picture that the order is for non-empanelled hospitals only:
https://wbxpress.com/treatment-in-private-nursing-home-80-reimbursement/March 12, 2012 at 12:13 pm #55441
insulin dependent diabetes patient, heart disease(bye-pass surgery done) patient,neurological patients ——have been submitting bills(for OPD treatment) for every month, the concerned medical institutions are also countersigning the bills in form D1,——————are all of the bills allowable to be passed for payment? pl advice early because the concerned employees are pressing hard for the same.March 13, 2012 at 5:02 pm #55442
My son became hospitalized on 22nd January 2012 for his treatment in Apollo Glenagles Hospital, but at that time he was 7+ months age having without WB health card. How my son will get benefit ? I am a WB Health card Holder.March 24, 2012 at 8:31 am #55443
Pse let me know the the clear list of OPD diseases come under wb Health scheme,2008. What type of diseases covered by sl. no. XI listed in form D1
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