PDA

View Full Version : By-pass Surgery - Refusal of permission



R K Rao
20-12-2012, 10:19 PM
I was diagnosed with a blockage in the main artery and was advised to get coronary artery bypass grafting (CABG).

The angiography was done by me in private hospital (for which I did not claim any reimbursement). Since CABG is a costly procedure, I had approached the CGHS Wellness clinic for referral to Fortis hospital (recognised under CGHS for CABG).

One of the officer there refused to grant permission saying that I should go to a Govt. hospital since my surgery is a planned one.

The Fortis is less than 1/2 KMs away from my house whereas the Govt. hospital referred by them is more than 15 KMs away.

I fail to understand if they are right. Is their stand right? If so, under what rules? If that is correct, then why Fortis has been recognized under CGHS and who can go there? [ For that matter there is one more hospital in the vicinity of my house recognized under CGHS and 2 more within a distance of 8 KMs].

I wrote to them that I am not in agreement with them and will not proceed with the CABG until I get requisite permission. So far there has been no reply from them.

Any advice?

RK Rao

ramanrao60
21-12-2012, 10:24 AM
cghs is a failed set up
so far op treatment was a disaster but some good hospitals were enrolled and inpatient treatment was OK

They want that little advantage also to go

their logic in your case seems to be weird
even in govt hospital also the tax [payer only has to bear the expense, albeit indirectly

it is better to have some medical insurance

don't neglect the cabg advise due to red tape

R K Rao
21-12-2012, 11:04 AM
Sir,

Thank you for your kind reply. I shall act accordingly.

RK Rao

Victor
21-12-2012, 03:24 PM
I was diagnosed with a blockage in the main artery and was advised to get coronary artery bypass grafting (CABG).

The angiography was done by me in private hospital (for which I did not claim any reimbursement). Since CABG is a costly procedure, I had approached the CGHS Wellness clinic for referral to Fortis hospital (recognised under CGHS for CABG).

One of the officer there refused to grant permission saying that I should go to a Govt. hospital since my surgery is a planned one.

The Fortis is less than 1/2 KMs away from my house whereas the Govt. hospital referred by them is more than 15 KMs away.

I fail to understand if they are right. Is their stand right? If so, under what rules? If that is correct, then why Fortis has been recognized under CGHS and who can go there? [ For that matter there is one more hospital in the vicinity of my house recognized under CGHS and 2 more within a distance of 8 KMs].

I wrote to them that I am not in agreement with them and will not proceed with the CABG until I get requisite permission. So far there has been no reply from them.

Any advice?

RK Rao

Please refer to the following which has been taken from the website of CGHS (http://msotransparent.nic.in/cghsnew/index1.asp?linkid=6&langid=1).

"Procedure for Reference

CGHS/ Govt. Specialist / CMO i/c advises specific treatment procedure / test.

Permission to undergo same at one of the recognized Hospitals / Diagnostic centre is granted by CMO i/c in case of pensioner CGHS beneficiaries ....... and by HOD in case of Serving Govt. employees ......."

Victor

R K Rao
21-12-2012, 03:26 PM
Thank you, Mr. Victor. I shall refer to the reference given by you and proceed accordingly. Thanks again.

RK Rao

SrCMO
25-12-2012, 10:48 AM
dear Rao sir, it is a requirement as per rules that CGHS or The HoD can issue permission for performing coded procedures on the advice of a govt Specialist. please refer to th OM in Gconnect in this regard. Unfortunately there has been no relaxation modification of this rule to date.: S-11011/6/96-CGHS (P).
(http://gconnect.gnaukri.in/download/cghs/circular-cghs-procedure-referral-recognised-hospitals-11-7-97.pdf)

R K Rao
25-12-2012, 11:26 AM
Dear [Mr SrCMO] Sir,

Nice of you. I shall go through the OM given by you. Thanks.

Regards

RK