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ICICI Lombard Expert Blog
 

Health Minister Says Claims Under PMJAY Scheme to Be Approved Within 30 Minutes

August 31 2018
Insurance

While unveiling the logo for the Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme, also called the Ayushman Bharat scheme, Health Minister JP Nadda said that pre-authorisation for health insurance claims under the PMJAY will be completed and communicated to the hospital within 30 minutes.

The pre-authorisation stage is a provisional sanction to keep false claims in check. Guidelines for pre-authorisation will be set by the PMJAY scheme and the process will be mandatory for 636 packages offered out of 1,350 packages.

When questioned about the crucial minutes that a patient would lose in case of an emergency situation owing to such procedures, the Health Minister said, “It will take half an hour.” The PMJAY scheme will be launched on September 25th, the birth anniversary of RSS ideologue Pandit Deen Dayal Upadhyay, as announced by PM Narendra Modi in his speech on Independence Day.

29 states and Union territories have already signed the MoU for the ambitious PMJAY scheme that is expected to reach 50 crore people across 10 crore households, informed Nadda. He added that around 10.74 crore poor families that are listed in the socio-economic caste census data will be covered by the ₹5 lakh health insurance and assurance scheme.

The Health Minister stated that the government is very serious about acting against fake websites falsely claiming that enrolment and payment of fee is required for the scheme. He also informed that the process of adding government and private hospitals in the scheme is ongoing.

The cost of diagnostic procedures, drugs administered three days before admission and two days after would also be covered under the scheme. While treatment at government hospitals is free, there are certain fees that are charged which will be covered under the scheme.

*Source:News 18

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