Jaipur: The state govt is implementing initiatives to enhance the financial stability of its hospitals by directing officials to ensure that claims under Mukhyamantri Ayushman Arogya (MAA) Yojana are not rejected by the insurance company due to deficiencies in claims filed under the scheme. Instructions were issued to all chief medical health officers, principal medical officers, and hospital administrators to properly execute the Rajasthan govt health scheme (RGHS) and MAA Yojana in their respective areas.
“The scheme ensures reimbursement for each OPD consultation under RGHS, while IPD cases receive compensation for actual expenses incurred, thereby creating a revenue stream for the hospitals. The funds generated will be utilised by the hospitals for improving their infrastructure and facilities,” said a state govt official.
Talking about MAA Yojana, the official said, “Directions have been issued to ensure that the deficiencies in the claims filed under the MAA scheme are completed by having them monitored properly. This will also increase the revenue of health institutions. If a claim is rejected, the insurance company benefits, and your hospital’s financial situation does not strengthen,” he said.
Under the RGHS, ministers, MLAs, ex-MLAs, All India Services, serving and retired employees of the state govt and of state autonomous bodies are beneficiaries. All RGHS beneficiaries have access to the cashless medical facility based on the Central Govt Health Scheme (CGHS) package rates as per the applicable medical rules for the respective RGHS category.
Under MAA Yojana, cashless treatment is provided in empaneled govt and private hospitals. Treatment can be availed under the prescribed package at all govt hospitals in the state, such as community health centres, satellite hospitals, sub-divisional hospitals, district hospitals, hospitals affiliated with medical colleges, hospitals of the Govt of India located in the state, and private hospitals associated with the scheme. The task of empaneling hospitals with the scheme will be carried out by the Rajasthan State Health Assurance Agency.
