Cashless insurance scheme keeps GRH coffers ringing

Rs.23 crore was received for 10,590 claims: Dean

Work to improve Government Rajaji Hospital building under way in the city on Thursday. Photo: S. James

The State Government’s health insurance scheme is filling the coffers of the Government Rajaji Hospital (GRH) here, thanks to the huge sums flowing in through insurance claims.

With reimbursements coming at a rapid pace under the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS), the hospital plans to utilise the money to upgrade infrastructure and equipment.

“So far, we have received nearly Rs.23 crore as claims amount for 25 departments, and 10.5 per cent of the amount is earmarked as Hospital Improvement Fund. The requirements of the departments can be easily met now,” N.Mohan, Dean, GRH, told The Hindu on Thursday.

There are certain guidelines to be followed in the implementation of the scheme, which was introduced last January. Of the total reimbursements received by the hospital, 60 per cent is to be used for procuring consumables required for treatment and surgical procedures, and 10.5 per cent for hospital improvement. The remaining amount will be used to meet the needs of the departments and distributed as incentives to doctors.

“As money is available for almost every department, the Heads of Departments are allowed to take decisions on purchases. Things have been decentralised and the overall monitoring is done by the District Collector,” Dr.Mohan said.

The total amount reimbursed to the GRH for 10,590 claims as of August 7 was Rs.22,75,74,149. The Department of Cardiothoracic Surgery topped the list with Rs.3.47 crore for 467 claims.

Dr.R.Raghunathan, Head of Department of Cardiothoracic Surgery, said the number of surgeries had gone up with the procurement of equipment under the scheme.

“Earlier, we had to depend on other sources for funds. But now the claims amount can be utilised for purchase of surgical items, upkeep of departments, improvement of wards, ventilators and other things,” he added.

According to him, the claims amount is credited to the special bank account within a week of the patient’s discharge. Right now, the Department of Cardiothoracic Surgery has placed an order for an imported heart- lung machine through the Tamil Nadu Medical Services Corporation.

Other departments which raked in substantial amounts through insurance claims included Cardiology (Rs.1.65 crore), Orthopaedics (Rs.2.6 crore), Medical Oncology (Rs.1.53 crore), Paediatric Surgery (Rs.1.25 crore) and General Surgery (Rs.1.76 crore).