Uttarakhand has emerged as a beacon of efficiency in healthcare administration within the Ayushman Bharat scheme. The state’s dedication to promptly settling insurance claims has earned it accolades and national recognition from the Ministry of Health and Family Welfare. This commendation will be officially conferred during a ceremony scheduled for September 26 in New Delhi.
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In Uttarakhand, a total of 248 hospitals, comprising 102 government and 146 private institutions, participate in providing free medical treatment, with coverage extending up to Rs 5 lakh for cardholders. Notably, while the National Health Authority (NHA) sets a standard period of 15 days for processing and disbursing claims, Uttarakhand has significantly expedited this process to a mere seven days.
Under the Ayushman Bharat scheme, individuals holding hospital cards submit claims for medical expenses to the State Health Authority, which conducts comprehensive audits of these claims. Following the verification process, payments are promptly disbursed to the hospitals. It is worth mentioning that in 2022, Uttarakhand received national recognition for its outstanding efforts in preventing fraudulent activities within the Ayushman scheme.
Uttarakhand’s robust response to fraudulent billing practices involving private hospitals, along with its successful recovery of erroneously disbursed claim amounts, garnered widespread acclaim from the Health Ministry. Consequently, all states were encouraged to adopt Uttarakhand’s anti-fraud model.
Dr. R. Rajesh Kumar, the Secretary of Health, disclosed that a recent video conferencing meeting convened by the Health Ministry to discuss the Ayushman scheme highlighted Uttarakhand’s selection for the National Award in Claim Settlement.
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To date, the state government has issued Ayushman cards to over 52 lakh individuals, resulting in an expenditure of Rs 1554 crore to provide free treatment to approximately 8.28 lakh cardholders. Uttarakhand’s unwavering commitment to efficient and transparent healthcare delivery continues to serve as a benchmark for other states to emulate.
