How to use Ayushman Card in hospital

How to use Ayushman Card in hospital
How to use Ayushman Card in hospital

How to use Ayushman Card in hospital

How to use Ayushman Card in hospital – After obtaining the card, it is critical to understand every aspect of the medical packages that are offered in order to compile a list of the illnesses that are covered by this program. In 25 distinct fields of specialization, including branches like cardiology, neurosurgery, oncology, pediatrics, etc., the program provides medicinal and surgical therapies.It is crucial to remember that you cannot claim your surgery and medical costs separately.

How to use Ayushman Card in hospital
How to use Ayushman Card in hospital

What is Ayushman Card?

The Ayushman Bharat Yojna, sometimes referred to as the Pradhan Mantri Jan Sangh Arogya Yojna, is a commendable program that aims to provide essential medical care to the country’s economically weaker regions. According to the plan, a specific group of residents are eligible to use these services, under which they are annually covered up to INR 5,00,000 for any necessary medical care. The government has also introduced the Ayushman Card, a distinctive identity card that can be used to immediately store and share any patient’s medical details.

The following step is to implement a totally cashless system for the more than 50 crore patients who will benefit from this program. Additionally, the project now has a list of about 1,400 free treatments, and as time goes on, more and more procedures are added. To locate and eradicate the disease, these treatments are carried out in 24 specialized verticals.

What is the hospitalisation process for Ayushman Card?

Although there is no set enrollment process, each patient must have a current government-issued picture ID card, such as a ration card, Aadhar card, or driver’s license, with them at all times while they are being hospitalized.During the hospitalization process, the patient must also have their Ayushman Bharat card with them in addition to the card listed above. The procedures for entering any hospital with an empanelled status that is covered by the Ayushman Bharat Scheme are listed below:

  • To generate an OPD ticket, enter any empanelled hospital’s OPD.
  • Consult a surgeon or medical professional.
  • If the patient is instructed to be admitted to the hospital following diagnosis, the expert will note the package code on the OPD ticket and carry out any necessary procedures-specific examinations.
  • If the patient is an Ayushman beneficiary, the nursing supervisor will recognize them and request their identity.
  • After that, the nurse will create an admission case sheet using the template.
  • The Beneficiary Identification System (BIS) will be used to verify the patient’s data.
  • For patients who are ambulatory, the verification can be completed at an Ayushman Bharat kiosk. Ayushman Mitra will administer the warranty in hospital wards for non-ambulatory patients.
  • Ayushman Mitra will use the Samagra ID (an 8-digit family ID) to search the patients’ information at the Ayushman Bharat kiosk.
  • If Samagra ID is not used to finish the search, the patient is located using their cellphone number, HHID number, or SECC name.
  • In the event that the search is successful and the patient’s data is located in the BIS, they may proceed to having their KYC completed.
  • The use of Aadhar and biometric fingerprint devices will be used for KYC (eKYC).
  • A non-Aadhar verification is carried out if the patient is non-ambulatory or the biometric device is not set up with the laptop or tablet.
  • The operator is expected to receive the permission (golden record cards made by ISA) within 30 minutes.
  • The nurse will stamp an Ayushman Bharat seal for simple identification on the front page of the case sheet once it has been approved.
  • Ayushman Mitra will register the patient on the Transaction Management System (TMS) following validation (creation of the golden card). The registration period lasts for five days after the admission date.
  • Ayushman Mitra will repeat the process, bearing in mind the reason for rejection, if the validation is rejected by ISA and SHA.
  • The nurse will send the case page to the kiosk for pre-authorization before starting the procedure.
  • The patient’s “on-bed photograph” will be taken by Ayushman Mitra and uploaded to the TMS.
  • Within two days after enrollment in the TMS, the Ayushman Mitra or the Medical Coordinator may raise the pre-authorization.
  • With the assistance of the Medical Coordinator, the Ayushman Mitra will then choose the surgical or non-surgical benefit packages according on the patient’s health. They are unable to combine surgical and non-surgical packages.
  • Within six hours, the ISA will decide whether to grant the request or not.
  • The designated nurse will deliver the patient’s daily clinical notes to the kiosk for TMS upload.
  • Ayushman Mitra will snap a “on-bed photograph” or any other post-surgical photo at the moment of discharge and upload it to the TMS.
  • Following the procedure, the TMS will save the information, and the patient will be released with a summary sheet.
  • The online discharge summary for the patient’s hospital discharge will be completed by the Ayushman Mitra.
  • If the patient passes away, they will raise a flag against the departed member, designating them as inactive or dead. They will also upload a death certificate.
  • The patient will be requested to complete a feedback form after being discharged in order to help the hospital enhance its Ayushman Bharat offerings.
  • Any claim that the hospital submits will either be accepted or rejected by the ISA.
  • The hospital will receive a rejection notice from the ISA if the claim is denied. The statement explains the hospital’s right to challenge the claim’s denial.
  • After the claim is approved, the hospital receives paid.

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