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West Bengal Health Scheme, 2008

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  • #55424
    WBXPress Team
    Keymaster

    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’.

    #55425
    WBXPress Team
    Keymaster

    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.

    #55426
    WBXPress Team
    Keymaster

    7: this facility is effective from the month in which medical allowance is deducted from your pay.

    #55427
    WBXPress Team
    Keymaster

    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.

    #55428
    WBXPress Team
    Keymaster

    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.

    #55429
    Anonymous
    Inactive

    Is the cost of health checkup reimbursed. This has been advised @ the OPD of Apollo Gleneagles as well as RNTIICS

    #55430
    Anonymous
    Inactive

    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 & reimbursed

    #55431
    WBXPress Team
    Keymaster

    reimbursement for follow up treatment is defined for particular diseases.

    #55432
    WBXPress Team
    Keymaster

    there is a list for OPD treatment which can be reimbursed. download sl no 30 for the list.

    #55433
    Anonymous
    Inactive

    Sir, please provide me a list of Enlisted ( Class-I & Class-II )Private Hospitals under WBHS-2008 with effect from 01-01-2012

    #55434
    WBXPress Team
    Keymaster
    #55435
    Anonymous
    Inactive

    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?

    #55436
    Anonymous
    Inactive

    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.

    #55437
    Anonymous
    Inactive

    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?

    #55438
    Anonymous
    Inactive

    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,

    #55439
    Anonymous
    Inactive

    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.

    #55440
    Anonymous
    Inactive

    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/

    #55441
    Anonymous
    Inactive

    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.

    #55442
    Anonymous
    Inactive

    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.

    #55443
    Anonymous
    Inactive

    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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