Dehradun: A joint review and coordination meeting of the State Health Authority and Ayushman/Golden Card empaneled hospitals held at Dehradun. Various issues were discussed, including the online portal, timely settlement of claims, invalid claims, and the review process. Participants also shared several suggestions for better implementation of the scheme.
Chairing the meeting, Authority Chairman Mr. Arvind Singh Hyanki said that ensuring the benefits of the Ayushman scheme reach every eligible beneficiary is a collective priority. Hospital representatives present in person and those connected online were given an opportunity to express their views one by one. During the discussion, they drew attention to both specific issues related to their hospitals and general issues faced by all hospitals.
The Chairman mentioned that due to technical challenges in the National Health Authority’s Transaction Management System (TMS) and the new review process, there have been some delays in settling hospital claims under the Ayushman scheme. However, efforts are now being made to resolve these issues swiftly. The goal is to process claim payments within 15 days.
In view of the difficulties related to reviewing older claims on the portal, the option of **offline reviews** will be provided, and the claim review system will be simplified. He also informed that the state is developing its **own TMS**, which will resolve current technical issues in the system. Efforts are being made at the Authority level to simplify processes and make them as **faceless and online** as possible, so that cases are resolved quickly and hospitals don’t have to make frequent visits to the Authority.
The Chairman also stated that hospitals are expected to fully focus on patient care and ensure that treatment bills are submitted accurately and in accordance with NHA and SHA guidelines and standards. This will help avoid objections and prevent unnecessary delays in payments. He emphasized the importance of **practical approaches** in operations, and said that competent authorities will make fair decisions in special cases based on merit. In case of any confusion, hospitals can contact the relevant SHA section or senior officials to clarify the situation.
Regarding issues related to Golden Cards, he stated that **budgetary arrangements** are being made, and the situation is expected to improve soon.
State Health Autority, CEO, Reena Joshi emphasized that continuous coordination between the SHA and service provider hospitals is essential for the effective implementation of the Ayushman scheme. She also stressed the need for mutual communication to maintain service quality and transparency. She directed hospitals to be trained to provide **free treatment** to victims of road accidents.
Himalayan Hospital, Mahant Indresh, Kailash Omega, Graphic Era, Panacea Hospital, Hans Foundation, and others participated in the meeting and presented their issues, most of which were resolved on the spot. Several suggestions for better implementation of the scheme were also put forward by the hospital representatives. They expressed satisfaction with the coordination meeting organized by the Authority and requested that such meetings be held every quarter, to which the Chairman agreed.
