a. Request letter from Card holder clearly indicating the name and address of the hospital.
b. Advise by Government Specialist recommending maintenance haemodialysis, clearly specifying the number of MHD per week.
c. Any proof of availability of haemodialysis facility in the hospital requested for. Preferably an advice from a treating specialist from the said hospital which will not only confirm the availability of the facility, but also the willingness to treat our beneficiary.
d. Copy of CGHS card.
· The permission is given for 6 months at a time subjected to reimbursement being restricted to CGHS RATES or actual whichever is lower.
· The permission is restricted to haemodialysis and does not entitle the beneficiary to claim towards other treatment or investigations at that hospital.
· The medicines should be collected from Wellness Centre.
· The permission can be issued to serving beneficiaries and also other city CGHS beneficiaries. However, the reimbursement shall be from their respective departments.
· Permission can also be issued for MHD at non-empanelled hospitals in other cities.
a. Covering letter from Card holder.
b. Duly filled claim form and bank mandate form and other relevant documents.
c. Copy of CGHS card.
d. Bill/Receipt (original) indicating the details.
e. Paid proof.
f. The original/Photocopy of permission letter.