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Mulukutla
04-01-2012, 06:29 PM
I am a CGHS beneficiary attached to Dispensary IV at Hyderabad. I am 85 years of age and my wife 75. The case relates to my wife.
She suffers from Filarial Lymphedema with intense swelling of right leg and moderate swelling of left leg for over 10 years. Off and on she gets attacks of Cellulitis on the right leg.
A month back she had a virulent attack of Cellulitis on the right leg and the Dispensary Doctor recommended admission in hospital for treatment. That was in the morning around 9 AM. Although he observed that delay could lead to Septicemia, he was reluctant to classify the case as Urgent.
Two empanelled hospitals refused admission, one on grounds that it is a super speciality Hospital and the other on grounds of non-availability of entitled accommodation and that CGHS has not considered that hospital for this ailment. All oral. But the rumours are that pensioners and their dependents are not welcome in most of the empanelled hospitals due to payment problems between CGHS and Hospitals. CGHS was requested to recommend another corporate hospital but they refused again orally saying that credit is not being accepted by that hospital and a number of complaints are coming from patients. In stead, another hospital was suggested but it is the prerogative of the beneficiary to chose the hospital. I did not accept it. By this time it was getting into late after noon and the patient was in distress. In desperation, she was admitted in a private hospital for a 5 day stay that costed me a whopping 70,000/-. What is the solution when Pensioners are treated as out casts by hospitals because of some difficulties with CGHS for payments etc. And CGHS does not intervene to set right matters? Everything is oral and nothing is given in writing. I have sent a letter to the Addl. Director, CGHS Hyderabad a 3 weeks or so back but got no reply.
What is the solution? To-morrow it can be a dire emergency.

ramanrao60
05-01-2012, 11:45 AM
The Hippocratic Oath is an oath historically taken by physicians and other healthcare professionals swearing to practice medicine ethically. But the same is practised more in breach than compliance.
CHGS is a terminally sick system and in urgent need of reforms
Better go for medical insurance.

amit2301
05-01-2012, 11:50 AM
Dear Sh. Mulukutla

write a properly formatted grievance to the DG of CGHS at New Delhi with a copy at http://pgportal.gov.in/Grievance.aspx

regards

Amit

Hyd_AG_Employee
05-01-2012, 03:25 PM
Respected Sir... your case is no different. It is the same with everyone. Now comes the question as to why CGHS recognised Pvt. hospitals do not accept pensioners but readily accept in-service patients is simple : The hospital bill in case of an in-service patient are settled by the department and the bill is put up and screened by an LDC or UDC and sanctioned and payment made . In case of pensioners' the bill is processed by a team of doctors at CGHS Begumpet Hyderabad. When a bill of an in-service patient is settled by the department generally 100% of the bill is paid. When the same bill is settled by the CGHS Directorate, not even 40% of the bill is paid as they will raise so many questions regarding the need to do the treatment done (as the bill is processed by Doctors and they know that the bill is inflated). So hospitals generally tend to avoid pensioners and encourage in-service patients. There is no solution to this problem. However you can always pay from your pocket and claim reimbursement from the directorate at a later date. But when you opt for this tell the hospital of this in advance so that they will charge you only CGHS approved rates and not their normal rates. This way even you will keenly see the bill in detail and object to over charges if any. Wishing madam a speedy recovery......

ramanrao60
06-01-2012, 01:02 PM
Dear Sh. Mulukutla

write a properly formatted grievance to the DG of CGHS at New Delhi with a copy at http://pgportal.gov.in/Grievance.aspx

regards

Amit

Please note that the thread initiator has already told that many of the refusals are only verbal and no supporting papers can be submitted by the pensioner.
In this scenario the representation is likely to fall on deaf ears.

The grievances in government are handled in a mechanical manner and simply forwarded to the concerned for "comments".
And then hide and seek game begins, leaving the complainant in the lurch.