The patients undergo treatment at the SMS Hospital and without completing the formalities of getting discharged from the hospital in a proper way, they abscond from the hospital.
“If a patient has left the hospital or absconded, the hospital does not get the claim of amount spent on his treatment by the insurance company roped in by the state government under Chiranjeevi Health Insurance Scheme. It is a major concern for us,” said Dr Achal Sharma, medical superintendent, Sawai Man Singh Hospital.
The hospital has come to know that there are cases of patients getting surgeries done here but go to private hospital for post-operative care after absconding from SMS Hospital. In some cases, they abscond without completing the treatment.
“The insurance company is rejecting our claims we raise for absconding patients. Around 20% of our claims are rejected and absconding of patient is the biggest reason for rejection. If the patient has decided to leave the hospital, they can ask the hospital to ‘discharge them on request’, we have no objection in discharging them, but they should not abscond, if they are absconding, they are causing revenue loss to the hospital,” said Dr Sharma.
The SMS hospital is taking measures to increase its revenue under Chiranjeevi scheme. On Wednesday, Sharma met the private company which SMS Hospital had hired to ensure that the claims are not rejected, and more patients get registered under Chiranjeevi scheme.
The hospital is already making efforts to encourage patients to get the treatment under Chiranjeevi scheme.
Despite efforts, a lot of patients admitted to SMS Hospital still do not submit details of their Chiranjeevi card to the hospital and prefer to get the treatment under Nirogi Rajasthan which is causing loss to the hospital and state government.
Under Chiranjeevi scheme, insurance company pay for their treatment but under Nirogi Rajasthan, hospital and the state government pay the bills of the patients to ensure that the patients get free treatment in government hospitals. The government has made treatment of patients free of cost in government hospitals.
The hospital authorities are making patients aware that if they get treatment under Chiranjeevi scheme, the insurance company will pay for the treatment but if they get treatment the hospital will pay for it.
If more patients are treated under Nirogi Rajasthan, it will be a loss to the hospital. Chiranjeevi scheme helps in generating funds for the hospital for its functioning.
