There are three types of claims which received by the Section.

1.      Claims received under ‘Direct Payment Facility’ in which an employee gets the in-patient treatment at the empanelled hospital under cashless facility.

2.      Claims received under ‘Reimbursement Facility’ in which an employee gets the in-patient treatment at the empanelled hospital by paying first and submit the claim for reimbursement.

3.      Claims received under ‘Out-Patient Deptt.’ (OPD) in which an employee gets the OPD treatment from the Authorized Medical Attendance (empanelled Doctors and OPD of empanelled hospitals) by paying themselves and submits the claim for reimbursement.

The following steps are involved in the processing of passing medical reimbursement claims:

(i)                Receipt and diary of medical reimbursement claim.

(ii)              To scrutinize and processing of the claim as per CGHS rules and rates.

(iii)            To raise objection, if any.

(iv)            To pass the claim.

(v)              To send the claim for release of payment to Account Section And;

(vi)            Payment being sent to the respective claimants’ savings bank account through ECS/NEFT.