REFERRAL PROCEDURE REFERRAL PROCEDURE

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Investigation/ procedure not available in CGHS & advised by CGHS / Govt. specialist Out-patient consultation only in Govt. hospitals Investigation/procedure either in government OR in private recognized centre. Government servants to take permission from parent department before undergoing treatment. Pensioners to take permission from CMO I/C Permission is valid for one month only

HOSPITALIZATION
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On prior permission from parent department OR CMO i/c in case of pensioners Pensioners get a credit form in triplicate authorized by the CMO I/C of the dispensary to the hospital recognized by CGHS. There is no need to pay money and later claim reimbursement for pensioners. Recognized hospital will send the bill to the CGHS Package rates have been fixed for different procedures and an agreement is signed by the recognized hospital for these rates Package rate includes ALL charges pertaining to a particular treatment / procedure including admission charges, accommodation, ICCU/ICU, monitoring, operation, OT, surgeons fee anesthetist fee, disposables, medicines, related routine investigations, physiotherapy etc. Package DOES NOT include diet, telephone, cosmetics, TV charges. M/o H &FW, Dtd 14-02-2003 Package rate is for semi private category For Private ward + 15% For general ward - 10% Maximum room rent General . 500 per day Semi private. 1000 per day Private.. 1500 per day Day care 500 per day o M/o H &FW, Dtd 14-02-2003

EMERGENCIES DEFINED 1. 2. 3. 4. 5. 6. 7. 8. Acute coronary syndromes Shock, acute limb ischemia CVA, convulsions RTA, Injuries Acute abdomen Acute poisoning Acute Renal Failure Acute Ob & Gynaec emergencies

Treatment taken in govt. referral hospital /private hospitals without prior permission :

Application explaining the emergency circumstances Emergency certificate from treating doctor Copy of card Break up of all charges To be submitted to the sanctioning authority of parent department

O.P.D. Treatment and follow-up is not allowed in CGHS recognised private hospitals and Diagnostic Centres. However follow-up treatment is allowed in following conditions for a period of 3-6 months after the surgery/procedure. a. b. c. d. e. f. Neuro surgery Cardiac Surgery including Angioplasty. Cancer Surgery, Radiotherapy and Chemotherapy. Kidney/organ transplant. Knee replacement. Road Traffic Accidents.