Posted by & filed under Esic-Circulars.

 Dear all,

A very Good move is made by ESIC Dept has given approval for allowing  ESI beneficiaries to seek medical services from the nearby empaneled hospital directly without a referral,  in case of Non-availability of ESIC Health care i.e. Hospital/Dispensary/IMP, etc. within a radius of 10 KM of his/her residence  

1. ESIC   empanelled   hospitals   as   per   following   operational guidelines:

2. ESI  beneficiaries of those areas (newly as well as already implemented) where no    ESIC/ESIS health  care delivery  facility i.e. hospital,  dispensary, IMP, etc. exists within the     radius of 10 KMs of IPs residence, shall be eligible

3. ESI  beneficiaries  of  such   areas  may  approach  nearest  ESIC impaneled hospital with    ESI card or print out of online Health  Passbook or “ePehchaan The letter” issued by the         employer for availingthe required  medical consultation

4.  Once the  ESI  beneficiary  attends  the impaneled hospital,  the  prima   face       verification regarding the identity  of the  beneficiary in  termsof genuineness shall be ascertained by the impaneled  Hospital after cross verifying with Aadhaar card  or any  Govt. issued  photo  I  Card.  Additionally,  the eligibility shall be verified through the UTI  application by feeding in the  IP Number.  UTI  portal has been integrated with the Panchdeep  Module of  ESIC. This verification shall be done by the person authorized by impanelled hospital for such purpose.

5. Once  OPD consultation   of  the  beneficiary  is  carried  out,   the impanelled hospital  shall   uploadthe  photo  of IP/ beneficiary and photocopy of Aadhaar on  UTI  portal along with bill raised at  CGHS  rate.  Further,  as  and  when Aadhaar is  implemented,  an   Aadhaar based onlineverification  system  shall be devised and incorporated into the system

Such    Beneficiarie may   see reimbursemen o purchase medicines prescribed 
during  OPD consultation  through  nearest  DCBO orRegional office where DCBO is  not available. Further,  an online system  shallbe developed in due course for processing and settlement of such reimbursement claims

( This means Once u take the  treatment from the nearest nearby empaneled hospital and as the medicines & the treatment cost which is spent will be reimbursed at the CGHS rate as defined )

Circular👉👉esic Benefites 10kms.pdf

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