Threaten withdrawal of services
Irfan Tramboo
Srinagar, June 9: The hospitals empaneled in Kashmir under Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (ABPMJAY) have not been reimbursed for their claims in last at least two months even after tirelessly providing the services to the ‘Golden Card’ holders of the scheme amid COVID-19 pandemic.
The office-bearers of the Association of Empanelled Hospitals told Excelsior that it is getting extremely difficult for them to keep the hospitals running as there has been a consistent delay in the payment of their claims.
“Some empanelled centres have not been paid for the last 2 and a half months. Many hospitals have to pay the bank loan which is totally impossible for us due to the delayed payments,” they said.
They said that it is clearly mentioned in the agreement that in case of delay in the payment to the Empanelled Healthcare Provider (EHCP), they have to be paid extra.
“If claim payment to the EHCP is delayed beyond a defined period of 15 days the Insurer is liable to pay an interest of 1% for every seven days of delays to EHCP in addition to the claim amount,” the contract states.
The administrators of these hospitals have threatened that if their payment is not released along with interest, they will be forced to withdraw the dialysis.
“We are being forced to withdraw the dialysis services through AB-PMJAY programme from July 12 this year onwards if the bills are not credited to our accounts to till date along with 1% interest and also payment of rejected cases on priority,” they said.
They further said that the State Health Agency, AB-PMJAY along with the Bajaj Allianz Insurance Company had unilaterally violated the agreement by resorting to the reduced package rate of hemodialysis by a whopping 25%. They said that it is a gross violation of the agreement.
“We are in a bad condition since August 5 last year only to be added post financial year 2020 due to the decrease in package rates for hemodialysis; it further piled up during Covid19 pandemic due to the skyrocketing rates of consumables and non-payment of bills,” they said.
The Association further alleged that many cases are being rejected without a genuine reason “even though we are trying our best to process the claims through erratic internet access.”
Nodal Officer, ABPMJAY for J&K Ata-Ul-Munim Tak told Excelsior that the pending payments will be released within few days in favor of the empaneled hospitals under the scheme.
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