PROCESS FLOW IN MEDICAL CLAIM PROCESSING

 

       Submission of claim at Parent Wellness Centre

o   Online entry by dealing official in DEO module and forwarding to CMO In-charge

o   Processing and forwarding the claim to head office through CMO In-charge module.

       CMO In-charge follows laid down guidelines for processing

       Dealing official arrives at Admissible amount

       Reexamined by CMO In-charge

       Forwards the claim to head office

       Processing by Technical Screening Committee (TSC)

       Dealing official ascertains admissibility of Claim from competent authority and processing guidelines from TSC.

       Examination by TSC

       Financial Approval of Competent authority and payment

       Financial approval of Additional Director CGHS Bengaluru (for cases with approved amount > 7 lakhs approval from ministry is necessary)

       Preparation of bill and Payment by PAO/Draft.