Mired in a situation between the devil and the deep blue sea , the beneficiaries of cashless treatment under the popular scheme of Ayushman Bharat Pradhan Mantri Jan Arogya Yojna in Kashmir valley seek the intervention of the UT administration as their medical claims’ settlement is feared to land in trouble. There are more than 3500 cases under the said Health Scheme which are pending in various private hospitals for disposal . Again, absence of internet facilities since August 5 in the valley is the root cause which has affected the functioning of the administrative wings of the essential services like hospitals , as the claims are not sent to the Insurance Company for settlement.
Needless to add, it is really the importance and the high utility of this flagship scheme of the Central Government coupled with its wide publicity rather awareness that in militancy torn Kashmir valley, people have welcome this scheme , for many much awaited , and opted to derive benefits from it . It is a reflection of extremely good and hard work of those in charge of this scheme that people across the country are acquainted with the tremendous benefits to the identified groups . That popularity and the utility was fraught with chances of getting dented if its benefits in tangible form did not reach the needy, much in case of those who already have got their medical treatment done at various identified or empanelled hospitals, if timely settlement of claims did not take place.
The private hospitals bereft of internet facilities are undone as to how the piled up claims could be sent for settlement of claims as alternate arrangements purported to have been kept at disposal by the Government are reported to be significantly insignificant. Most of the owners of such hospitals chose to travel all the way to New Delhi to personally deposit the claim papers with the concerned Insurance Company but most of them are reported to have experienced as many fresh cases having arrived under the scheme for disposal. Sending by post too is found to be time consuming as any query , clarification etc from the Insurance company would not reach them by post looking to enormous work load at such offices of the Company hence the problem.
The problem is not confined to this extent only . A new Insurance Company was to take up the business under the said scheme from December 1 as the period of agreement with the present Company was going to be over on November 30 within which period, the claim cases are bound to be sent to them for settlement. Old cases obviously, therefore, cannot be sent to the new Company as they would not settle them . If the stalemate continues like that, it is feared that the beneficiaries might have to pay right through their nose which means unwarranted and avoidable feelings towards the broader objectives of the scheme to help those who could not bear the medical treatment expenses. It may be noted that the Chief Executive Officer (CEO) Ayushman Bharat Pradhan Mantri Jan Arogya Yojna , J&K has already written to the designated hospitals , both public and private to register pending cases for payment immediately.
Agreed that these hospitals are given a slot to upload the details of the cases once in a week by the Insurance Company but that does not solve the problem as on day to day basis, the number of the cases was piling up. Why cannot the hospitals be provided , at least, with limited internet services for an hour or so daily to help them proceed with the procedure towards settlement of the cases? This could be seen also in the light of the directions given by Lieutenant Governor Girish Chandra Murmu to the Department of Health and Medical Education to make efforts to provide internet connections to all the hospitals for implementation of this scheme. However, the CEO has assured to allow the use of internet facility to these hospitals at the office of the ‘State’ Health Agency , if they so wanted. He has , however, assured to do more for registration of the cases under the scheme, that being an assured positive approach towards resolution of the issue.
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