GUIDELINES TO PENSIONER BENEFICIARIES WHILE SUBMITTING THE MRC

 

We, at MRC section of the CGHS Bengaluru strictly follow the laid down Ministry’s guidelines and every effort is made to reimburse the admissible amount as timely as possible by following the applicable CGHS rates. We seek your kind cooperation in this regard by adhering to guidelines issued from time to time.

            

·       MRC will not be accepted in the Administrative Head Office. They should be submitted in the parent Wellness Centre.

·       The other city card holders are also requested to submit the claims preferably at the parent Wellness Centre of their respective CGHS city.

·       It is the responsibility of the claimant to provide all the required documents.

·       Kindly enclose all required documents with a request letter explaining the circumstances for availing emergency treatment.

·       Arrange all the bills in chronological order and prepare a summary of all bills.

·       No payment can be made against Provisional or Running or Intermediate or Interim bills.

·       No payment can be made against photocopies of the bills.

·       No outpatient (OP) medicines can be reimbursed and they shall be collected from Wellness Centre.

·       It is mandatory to submit original invoice for reimbursement of Implants/ Stents/ Costly Medicines, etc.

·       Non-medical expenses are not covered under CGHS and hence expenditure incurred in this regard is not admissible as per CGHS Guidelines.

·       Kindly enclose the original paid proof for all the bills enclosed unless enclosed bill is "bill cum receipt".

·       Amount claimed, actual amount paid to hospital (receipts) and the hospital final bill amount should tally.

·        Reimbursement is subject to examination of the case by technical screening committee.

·       All Documents should be submitted in duplicate. However, it is advisable to keep yourself, one set of all claim documents for your reference. However, in case of bills above Rs 7 lakhs submit three copies as the bill has to be forwarded to ministry for necessary financial approval.

·       Kindly make use of nomination facility.

·       Kindly enclose the bank NEFT details (only of the claimant) as the payment is settled by Electronic clearing system.

·       In order to minimize the economic burden on the beneficiary, it is preferable to take treatment in Govt. Hospitals/ CGHS empaneled HCOs on the advice of Govt. Specialists opinion instead of in Non-Empaneled HCOs who charge as per their rates. Cashless facility is available at empaneled hospitals even in emergency cases.