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State Bureau, Dehradun. The State Health Authority (SHA) has implemented a time bound action plan for settlement of pending claims of hospitals empaneled under the Ayushman Scheme.
Authority Chairman Arvind Singh Hyanki has said that disposal of all pending claims will be ensured by March 31 under all circumstances.
For this, daily monitoring of the claim process, special meetings of committees and target based responsibilities have been assigned to the personnel.
At present, claims related to payment for treatment of various hospitals and personnel are pending with the State Health Authority in the state.
The authority has attributed this to technical reasons and erroneous presentation. Besides, SHA has also sought financial help from the state government for these payments. Not only this, the process of payment of pending claims is being expedited at the level of the National Health Authority.
Authority Chairman Arvind Singh Hayanki said that the Transaction Management System (TMS) portal operated by the National Health Authority was upgraded from TMS-A to TMS-2.0.
While transferring the data of the old portal to the new portal, many technical problems were encountered in the initial phase. Due to this, the process of verification and payment of claims was affected and a large number of cases remained pending.
He said that now the portal is working completely smoothly. Claim Review Committee (CRC) and Medical Audit Committee (MAC) have been activated to review pending claims. Immediate payment of claims which are found true in the test will be ensured.
Claims Director of the Authority, Dr. Saroj Naithani said that about 65 thousand claims were pending in CRC and more than 55 thousand claims were pending in MAC. Till now, more than eight thousand cases have been resolved and the payment process has been taken forward. He expressed confidence that the target of 100% disposal will be achieved within the stipulated time.
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