Disposal of ‘Need More Info’ (NMI) Cases in online processing of Emplanelled Hospital Bills: ECHS

Central Organisation ECHS

Adjutant General’s Branch

Integrated HQ of MoD (Army)

Maude Lines

Delhi Cantt- 110 010

20 Jun 2017

1. Please refer para 5 of Med Section, Central Organisation ECHS e-mail dated 03 Feb 2016. (copy attached).

2. The online bill processing was initiated for efficient and timely settlement of hospitals claims while maintaining transparency between the ECHS beneficiaries, Hospitals, EPA and Central Org ECHS. However of late, it has been observed that empanelled hospitals are not responding to the queries raised by the EPA within stipulated time frame, thereby, delaying the final settlement of claims. Numerous empanelled hospitals are now seeking for ‘one time waiver’ for delay in query reply to NMI duly recommended by respective Regional Centers.

3. It is seen that approximately 48,000 claims amounting to Rupees 60.5 Crore are pending for NMI disposal for more than 180 days and almost 1.5 Lakh claims amounting to Rupees 262 Crore which are in NMI for less than 180 days. Such a large amount of funds being stuck in the system for want of queries which are not responded to in a time bound manner can lead to inefficiencies in overall bill processing. Hence, in order to clear the pending NMI cases in the system, as a special measure, a waiver window for delay in NMI submission shall be provided. This one time waiver window period will be effective wef 15 Jul 2017 to 15 Sep 2017. UTI-ITSL is requested to flash on the hospital login screen this information immediately and activate all delay in NMI cases for this period only. In addition, forward a summarized list to all hospitals for action in NMI cases. Following disclaimer with ‘Agree Button’ to be displayed on the hospital login:-

“We have checked all the ‘Need More Info’ claims pertaining to our hospital. We, hereby agree to utilize this window period from 15 Jul 2017 to 15 Sep 2017 for clarifying any queries; We, also accept that after this period all our claims will be processed with available documents and we shall not contest the final settlement”

sd/-

(ADM Anand)

Col

Dir (Stats & Automation)

for MD ECHS

Encls: As above.