Advisory on claims settlement

Central Organisation ECHS
Adjutant General’s Branch
Integrated HQ of MoD(Army)
Thimayya Marg,
Near Gopinath Circle
New Delhi- 110 010

B/49778/AG/ ECHS/Claims/Policy

02 Feb 2023

(All Regional Centres)

ADVISORY ON CLAIMS SETTLEMENT RELATED TO ONCOLOGY RELATED TREATMENT

1. There has been a noticeable increase in Oncology related treatment at Empanelled Hospitals. The proportion of expenditure on Investigation and Treatment will definitely have an impact on bill settlement for other morbidities considering fiscal limitations Some RCs esp at metros have reported an increased preference amongst HCO’s for prescribing costly investigations within powers of SEMO which necessitate approval by Senior Advisor Oncology to justify its indication and prevent misuse.
2. The following measures are advised to check unnecessary investigations and Chemotherapy on the online BPA billing portal:-

(a) Chemotherapy Most oncology drugs are single use and therefore uploading of the vial wrapper is essential and uploaded as one image, preferably as a printed sticker with following details:-

• (i) Claim ID.
• (ii) Name of Patient.
• (iii) UHID if empanelled Hosp / IPD.
• (iv) MRP of the drug with batch/lot no same as in invoice.

(b) Use of Aprepitant Inj. Admissible, if patient on multi drug chemotherapy view high emetogenic potential. The vial must have details as reqd for Para (a) above.

(c) Investigations Cancer specific investigation above 2 Lakh must be accompanied by approval on Appx ‘A’ recommended by Sr Adv (Oncology) if it is unlisted and not only SEMO.

3. It is requested that this advisory be forwarded to all HCO’s under your jurisdiction for implementation w.r.t Oncology related bills processing.

4. This has the approval of MD ECHS.

(Rajesh Batlish)
Surg capt
OIC Claim
for MD ECHS

The post ECHS – ADVISORY ON CLAIMS SETTLEMENT RELATED TO ONCOLOGY RELATED TREATMENT appeared first on CENTRAL GOVERNMENT EMPLOYEES NEWS.

Central Organisation, ECHS
Adjutant General’s Branch
Integrated Headquarters
Ministry of Defence (Army)
Maude Lines
Delhi Cantt-110010

B/49773/AG/ECHS/Rates/Policy

06/12/2013

All Regional Centres

USE OF INJECTABLES (ANTI VEGF AGENTS)

1. Further to this office letter No B/49762/AG/ECHS dt 19 Aug 13, addressed to Regional Centre Pune with copy to all Regional Centres.

2. It was observed that the empanelled facilities were taking approval on Appx ‘A’ forInj Avastin for Ophthalmic use and there was a wide variation in rates. The issue was deliberated in consultation with service Ophthalmologist and Rs.2000/- (Two thousand only) per dose of Inj Avastin for Ophthalmic use be applied across all ECHS empanelled institutes.

3. The cost of the procedure (CGHS code 147) will be over and above cost of the Injection.

4. The rates will be applicable from 01 Jan 2014.

sd/-
(Vijay Anand)
Col
Dir (Med)
for MD

Source: www.echs.gov.in
[http://echs.gov.in/images/pdf/med/Med90.pdf]

The post ECHS Orders – Use of Injectables (Anti VEGF Agents) appeared first on CENTRAL GOVERNMENT EMPLOYEES NEWS.

The post Medical procedures are same for all categories of CGHS and ECHS beneficiaries… appeared first on CENTRAL GOVERNMENT EMPLOYEES NEWS.