Guidelines for Medical Treatment under W.B. Health Scheme
December 30, 2011 at 5:45 pm #62161
WBHS beneficiaries often face a lot of problems e.g. Improper Medical facilities from empanelled hospitals nursing homes, difficulties while reimbursement of medical bill for final settlement. https://wbxpress.com/guidelines-for-medical-treatment-under-wbhs/February 18, 2012 at 4:40 pm #62162
I,a pensioner enrolled under WBHS2008,have a dual chamber PACE MAKER installed prior to WBHS 2008 came into existence. Its replacement when required will have to be made on emergency basis by a dual chamber PACE MAKER only. I presume that no prior permission but only an intimation will be required in such a case. Further, will prior intimation through FAX be sufficient? I seek confirmation.—J.C.DeMarch 10, 2012 at 4:21 pm #62163
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 (http://www.wbfin.nic.in/writereaddata/Alphabetical%20list%20of%20H.C.O.s.pdf). Desun Hospital’s empanelled code is: 0411001.
Thus, I am eligible for reimbursement as Desun Hospital is an empanelled hospital. Further Sir, the Order No 10539 F [MED] dated 21/11/11 gives a clear picture that the order is for non-empanelled hospitals only.May 4, 2012 at 11:38 am #62164
sir,I enrolled for w.b. health scheme from where I retired as advised. I’m drawing pension from Salt Lake treasury. But now a retired employ can enroll for the scheme at the Directorate,Bikash Bhavan in caseof Higher Edu.Departt. I,m now unable to travel a great distance — my office from where I retired to submit my claim to the DDO.Now I wish to pray for transfer of my record of enrollment to Bikash Bhavan, Salt Lake. Kindly advise.May 4, 2012 at 9:41 pm #62165
Sir, I don’t think it is necessary. You have already got your health scheme card, I hope. While claiming reimbursement, the card itself is the record of your enrollment.May 5, 2012 at 10:09 am #62166
sir, though I am in possession of health card issued by the DDO jhargram Raj College, can I submit my claim at the Directorate, Higher Education Bikash Bhavan, Salt Lake ? Can I get the reimbursement from Bikas Bhavan ? At present I am a pensioner settled at Salt Lake. Kindly enlighten me.May 26, 2012 at 6:00 pm #62167
I am a member of West Bengal Health Scheme-2008 and had to admit in RUBI GENERAL HOSPITAL LTD, KOLKATA for Operation “Open Reduction & Internal Fixation (Code No. 01026030) on 10.4.2012. Operation dt.11.4.12 and Discharge dt. 13.4.12.
I had to pay to RUBI GENERAL HOSPITAL a total sum of Rs.40,720/-(Rupees Forty thousand seven hundred twenty) only (Rs.35,000/ against O.R.I.F-01026030 + Rs.5,720/- cost of Equipment prooocedure and other charges) as per their final Bill.
May I able to received the total amount Rs.40,720/- submitting the original bill and others papers to D.D.O. as per norms.
Kindly reply.May 26, 2012 at 8:59 pm #62168
You are eligible to get 100% of the approved package rate of code no. 01026030 i.e. Rs. 35,000/- irrespective of your category/ Group.
Now, the second part, if consists bed charges etc. (which depends upon the category of the employee) will be admissible according to your category.June 19, 2012 at 11:33 pm #62169
I have WB Medical Health Scheme Card. Are dependent father and mother in law who are also senior citizens be included in my card.They have no monthly income or drawing any pension either.November 18, 2012 at 5:30 pm #62170
Sir, Kindly give me details about claiming re imbursement.
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