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CGHS Beneficiaries: Guidelines for Referral to Empanelled Hospitals PDF

April 19, 2023 by hani Leave a Comment

The Directorate of CGHS under the Ministry of Health and Family Welfare has released an office order to help CGHS beneficiaries who face difficulty in obtaining a referral to empanelled hospitals when they are unable to visit CGHS Wellness Centers in person.

As per the office order, CGHS Medical Officers can issue referrals for consultation/endorsement at empanelled hospitals without requiring the beneficiary’s physical presence if the request is supported by relevant documents submitted through a representative. If necessary, the Medical Officer may also contact the beneficiary through video call or make a domiciliary visit. The Addl. Directors of CGHS Cities/Zones are advised to share the order with CMOs In Charge and other CGHS staff to ensure that the guidelines are implemented effectively.

Referral to empanelled hospitals for consultation/endorsement

Misc. 01/2023/DIR/CGHS/
Govt. of India
Min. of Health & Family Welfare
Department of Health
Directorate of CGHS

Dated the 31st March 2023.

OFFICE ORDER

Subject: Referral to empanelled hospitals for consultation/endorsement – regarding

With reference to the above-mentioned subject the undersigned is directed to state that this Ministry is in receipt of representations regarding difficulties being faced by CGHS beneficiaries in obtaining referral to empanelled hospitals by CGHS, when they are not in a position to visit CGHS Wellness Centers physically. In view of the representations. as referred to, this matter has been reviewed by this Ministry and it is now decided to issue the following guidelines in this regard:

  • Whenever there is a request for a referral for consultations/endorsement submitted through a representative by a CGHS beneficiary, where the beneficiary is not in a position to attend CGHS Wellness Centre physically, CGHS Medical officer, based on the documents submitted, considers that the request is justified, may issue referral to CGHS empanelled hospital for consultation/endorsement, as the case may be, without insisting on the physical presence of the concerned CGHS beneficiary.
  • If CGHS Medical Officer is not satisfied with the papers submitted through the representative, he/she may avail the option of contacting the CGHS beneficiary by video call or making a domiciliary visit to satisfy the requirement of referral/endorsement and shall not insist on the physical presence of such CGHS beneficiary.
  • Addl. Directors, CGHS of Cities/Zones shall circulate a copy of this Office Order to CMOs In Charge and other CGHS Staff to take necessary action and to monitor the implementation of the guidelines.

(Dr. Manoj Jain)
Director, CGHS

Source
PDF

Filed Under: Government

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