Monday, March 15, 2010

Cpl Bhandari case at Jabalpur

Kuthiala Sir,
This case continues to get deeper into needless issues. WE have been in picture from Day one.
An accident, at the very least with a fracture "would constitute 'emergency'.
On Reporting, there was some confusion about the empanellment. You would recall that till the Polyclinic asked for the documents to be submitted through the hospital, we were thinking we were dealing with a non empanelled hospital. This stage was the first indicator (and we spoke about it in detail) that it was an empanelled hospital with an identical 'pay first, claim and then be reimbursed the ECHS cleared amount' philosophy followed in Mrs Jogelkar's case. While on the issue, you will recall we checked on web and did not find the hospital in the annexure of empanelled hospitals. This deepened the mystery.
Be that as it may, the Hospital had NO business to charge and then reimburse ECHS rates to the veteran. They are ONLY ENTITLED to ECHS rates, including audit deductions if any, and must therefore reimburse the TOTAL amount.
We need to convey to the hospital that there is no getting away from this, and it would be a no holds barred action by us, jointly, to ensure they honor what they are committed to, in being an empanelled hospital.