Emergency Treatment in CGHS
Hospitals
CGHS Hospitals – Getting
treatment in emergency conditions
Under emergency conditions,
the empanelled hospitals are expected to provide treatment of CGHS
beneficiaries in all available specialities…
Private hospitals have been
empanelled under CGHS only for such specialities for which they are
eligible as per the terms and conditions of empanelment. However under
emergency conditions, the empanelled hospitals are expected to provide
treatment of CGHS beneficiaries in all available specialities.
“Emergency” shall mean any
condition or symptom resulting from any cause, arising suddenly and if not
treated at the earliest opportunity would be detrimental to the health of
the patient or shall jeopardize the life of the patient".
CGHS beneficiary attending
hospital in emergency: In such a situation the Hospital shall intimate to
BCA within 2 hours of admission and BCA shall respond in 4 hours (however
treatment shall not be denied to any CGHS member and this is only an initiation
of the e-workflow). Post discharge hospital would upload bills and
download documents as per requirements of CGHS within 72 hours.
TREATMENT IN
EMERGENCY
In emergency the hospital
shall not refuse admission or demand an advance payment from the beneficiary or
his family member and shall provide credit facilities to the patient whether
the patient is a serving employee or a pensioner availing CGHS facilities, on
production of a valid CGHS card and the hospital shall submit the bill
for reimbursement to the concerned Deptt. / Ministry / CGHS. The refusal
to provide the treatment to bonafide CGHS beneficiaries in emergency cases
without valid ground, would attract disqualification for continuation of
empanelment.
The following ailments may
be treated as emergency which is illustrative only and not exhaustive,
depending on the condition of the patient :
Acute Coronary Syndromes
(Coronary Artery Bye-pass Graft / Percutaneous, Transluminal Coronary
Angioplasty) including Myocardial Infarction, Unstable Angina, Ventricular
Arrhythmias, Paroxysmal Supra
Ventricular Tachycardia,
Cardiac Temponade, Acute Left Ventricular Failure / Severe Congestive Cardiac
Failure, Accelerated Hypertension, Complete Heart Block and Stoke Adam attack,
Acute Aortic Dissection.
Acute Limb Ischemia,
Rupture of Aneurysm, Medical and Surgical shock and peripheral
circulatory failure. Cerebro-Vascular attack-Stokes, Sudden
unconsciousness, Head injury, Respiratory failure, decompensated lung disease,
Cerebro-Meningeal Infections, Convulsions, Acute Paralysis, Acute Visual loss.
Acute Abdomen pain.
Road Traffic Accidents /
with injuries including fall. Severe
Hemorrhage due to any
cause.
Acute poisoning.
Acute Renal Failure.
Acute abdomen pain in
female including acute Obstetrical and Gynecological emergencies.
Electric shock.
Any other life threatening
condition.
Source: CGEN.in