Tele: 25683478 Central Organisation, ECHS Mil: 36833 Adjutant General's Branch Integrated Headquarters Ministry of Defence (Amy) Thimayya Marg, Near Gopinath Circle Delhi Canit-1 10010 8/4977 4/AGIECHS/Referral/2020 QO May 2020. JHQ of MoD (Navy)/Dir ECHS () DAV, Subroto Park HQ Southern Command (WECHS) HQ Eastern Command (A/ECHS): » HO Western Command (VECHS) HQ Central Command (VECHS) HQ Northam Command (ECHS) HQ South Western Command (AECHS) . HO Andaman & Nicobar Command (WECHS), . All Regional Centres PL ref Gol MoD (DoESW) lelter No 2219 (08)201SKWWEY/DIRRes) dated 03 Feb 2020 py att), cl Speci under ECHS st the came hospital, (Re 30 di same Hospital within al sh ion upto 03 times Referral st Iretjuiced during a sin ha maximum of 03 diffe @ valid for consultation wy gic visit (d) Advice of ECHS Medical Officer! § for a period of 30 days. (©) _ Advice of Et valid for a period of 03 months, investi: a medical em: if any fi sequited urgently the same Hospital2 3 ECHS beneficiaries aged 75 yoars and above shall be: permitted to seck direct OPD Consultation from Specialists of Private Hospilats Empanelied under ECHS without referral from ECHS Polyelinic. However, medicines prescribed will be collected only from Polyctinic. If ary investigations! procedures ere advised and are required in emergency, no other authorization is required and the same may be underiaken. However, in non-emergency conditions approval of competent culhiiity is required ff any nonfsted investigations! procedures are advised. Medicines prescribed will be collacted only from Polyclinics. 4. Gritically i EGHS beneficiaries shall he permitted for follow up treatment in ECHS Empanelled Hospitals as per the details given under: (2) Permission/Roferral for post-operative follow-up treatment in respect of following post-operative conditions requiring frequent Consultations from Specialist at Private Hospitals Empanelled under ECHS aed not be re validated from time fo time on cach occasion of the follow up treatment which may be under taken at CGHS rates without dime fit. However it is advized to pationts to revalidate the referral fram PC once in six months. ib) The consultations investigation are permitted tinder these fellow-up cases. The conditions covered are:- () Pest Cardiac Surgery Cases including Coronary Angioplasty, (ii) ~ Post Orgen transplant Cases (Liver, Kidney, Heart ot) (ii) Post Neuro Surgery Cascs/ Post brain Stoke ceses requiting raguter follow-up treatment. / (iv) End Stage Renal Disease! follow up cases‘of Liver Failure. () Caneer treatment. (vi) Auto-immune disorder like Rhewmaloid Arthritis requiring regular follow-up, (vil) Neurological disorder ike Dementia, Alzheimer's disease, parkinsonism ate, (c) Medicines prescribed may be provided by ECHS Polyclinis, (a) However, if any non-listed invastigation/ procadure are advised, during the follow up permission/ referral from competent authority shall be required except in ernergency. = Contd ni 33 §, The action to be taken by various agencies are enumerated in the succeeding paragraphs: (a) (b) Action fo be taken by Polistinics/Ragional Centres, 0) Referral shall be:valid for consultation upto 03 times in the same Hospital within 30 days. Validity of ID once used during the first visit needs (o be extended for the next two visits also. Necessary changes in the UT! website will be carried out by CO ECHS. (i) Refertal shall be valid for consultation with a maximum of 03 different Specialists, if required during a single visit, if the specialist at Hospital suggests for cross consultation then the sai the OPD note. (ii) Separats dropdown menu in the BPA portal for uploading the claims by the Emp hospital in tio veterans above 76 yrs age who have been neil not are emergency cases will be mace by BPA. (i) Validity of referral is nol exceeding 30 days. (¥) Not more than three qunsultations have been taken’en one referral, jalists have been consulted on one referial with, (a) Not mere than due justification in ci ree. sal Notas, (vil) Ali pts as per Para 2 above are to be checked. (vill) 19 Case of veterans more than 75 yrs of age, the isis will be generated without any referral fram the PC oly for OFD consuliation and omergency procedures, Referral will be required for nan'emengency proved: Astic ()— Allpts mentioned in Para 2 will b: t Hosps. Emp Hosps will ensure the fottow! taken} plemented th letter and spirit. (i) For Para2 (fj, the info to PC is sent within 48 hows, (ii) For Para3 the claims will be uploaded in the separate dropdown menu of BPA portal for veterans more ti 75 yoars of ago who have been neither referred nor aré emergency cases (wv) For Para 4 the hosp wil advise patients for a review at PC afler six months. Contd ,.....4/-(©) Action to be taken by BPA, f) SDCPL. Nis requested to incorporate the default provisions in referral goneration module of software as mentioned vide Pera 2 to § above, at respective touch points and confirm imple ion status within seven days. A workflow in respect of same shauid also be submitted. (ii) UTHTSL. It is requested to incorporate provision mentioned vide Para 2 to 5 above in the claim initiation and referral acceptance procedure of empanelled hospitals in your online’ module and submit the workflow for same. The BFA teems should also advised to take a note of these provisions in processing of online bills. This policy shall be effective from date af issue of Gol MoD (DoESW) latter mentioned para 1 of this letter. 7. For youir info and necessary action ol Qua (Anupam N Adhaulia) Col Dir (Med) for MD ECHS MeD (DeGSW) + for info wet you etter uncler ref DGAFMS/DG-3A, OGMS (Ammy)(DGMS-5(8) OGMS (Navy)iDir ECHS (Naw) DGMS (Air Fores) (Med-7) oGDs CGDA for info please, UTHTSI. - for info please. 183/1, Above Farico Show Room First Floor, Old Madras Road Halasuru, Bangalore Karnataka-560 008 internal (Qps & Coord) See, Claim Sec Slais & Automation See = for uploading the letter on ECHS website and issue of necessary direction to BPA as per Para 5 (c),Med No.22D(08//2019/WE/D(Res) ‘Government of India Ministy of Defence (Department of Ex Servicemen Welfare) Room No. 221, 8 Wing Sena Bhawan New Delhi, Dated¢:; February, 2020 Chief of Naval Staff Chief of Air Staif Revision of Guidelines regarding simpiffication of Referral Systems under ‘The undsrsignes Is directed (0 refer to Ministry ef Health & Family Welfare OM Ne. ZISQ2517120+7/DIRICGHSIEHS dated 40" December, 2018, OM NO SO2S/S5/201N1GIRIEGHSICGHS. (P) dated 25" May, 2019 and OM NO. 215025/25/2019/DIRICGHSICGHS(P) dated 29" May, 2019 and convay the approval of tee Competent Authority io meke the provision of aforesaid OMs of MoH&FW feto ECHS: beneficiaries, as here under: () Referral from ECHS Medical OfficeVECHS Specialist for consultation with Spaciglisl at Private Hospitals empanetied under ECHS. shall be valid for 20 days In the seme hospital - (i) Referral shall be valid for consultation upto 03 times in the same hosoital | 7. 10 daye, : til) Retérral shall’ bs valle for consultation with @ maximum of 03 dp P is, iF required during a single. visit. . ms)2 ECHS beneficiaries eged 75 years and above shell be pamnitied to seek direct OPD Consultation fiom Specialists of Private Hospitals Empanelled under ECHS without referral from ECHS Polelinic However, medicines preserbed will ba collsatsd only trom Polyeiinies. If any favestigstionsy procedures are advised and are required in emergency, no athet eutherization is required and the same may be undertaken. However, In Roa-emergency conditions appreval of competant authority is required if ted invest advised. Medicines prsseriped will be ied ouily fromm Polyoarses. Gritically if! ECS ‘aries sitall be panmitied for follow up treatment in smparislled Hoepitals ag ser the details given under! is) Peniission! Referral for post-operative follow-up (realment in respect of ‘ollowing postoperative conditions requiring frequent Consuitatien from ecialist'at privat hospitale empanelled uncer ECHS need not be fe validated from time te tine and folow-up treatmant may ba under tekan at CCHS rates without time sient, Tie cons The coaditions severed are: ion are permitted under thess follow-up cases. {) Post Cardiac Surgery Cases including Coronary Angioptasiy, {il] Past Organ tensplan! Caves (Liver, Ktdney, Heart ete) (i). Post Neuro Sergery ©: ses! Post brain Stroks cases requiting regular follow-up weatment, (i) End Stage Renal Disease! follow up cases of Liver Failure. WW) Canéer treatment. ta o-immune disorder like Rhgumstold: Arthritle recuiring re towetis (ui) jopical disomier fike Dementia, Asonism ete, ings presoribad may be provide Nya (6) However, if any norvlisted investigation’ procadure are advised: permission) referral irom competent authority shall be required except In emergeney. 4 This issues with concurrence of Ministry of Defence (Finance/Pension) vide their U.0. No. 2217201 9Fin/Pen (Part) dated 28.1.2020. \ Che / (akikarn) Under Secratary to the Govt, of India Copy l |. CDA, New Delhi 2. PPS to Seoretary(Detence/Finance) 3. JS (ESW} 4. DFA (Pension) 5. D (Medical) 6. O&M Unit fs We, CUMS