In line with partial modification in referral system by CGHS related guidelines for referral procedures for Consultation, Investigation and Treatment in Government and Private Hospitals (empanelled with ECHS) under ECHS are as per details given below.
Treatment at Private Empanelled Hospital.
(a) Single Referral for Specialist Consultation.
A referral issued by any Medical Officer of an ECHS Polyclinic will be valid for 3 months. During this period the beneficiary may consult two more specialists i.e. up to total of three specialists, if recommended by the primary specialist. A maximum 6 consultations shall be allowed during this validity period of 3 months.
(b) Investigation and Treatment Procedures Advised by Specialist of Empanelled Private Hospital After Referral by ECHS.
No further referral from ECHS PC shall be required for undergoing routine listed investigations and minor procedures, not requiring admission in the hospital as advised by the specialist, within the validity period of 3 months from the date of issue of the initial referral. However, Referral from ECHS PC shall be required for special investigations like CT Scan, MRI Scan, PET Scan and any other investigation costing over Rs. 3,000/- and the referral will be valid for 3 months.
(c) Correspondingly, referral would be required from Medical Officer of ECHS PC for any procedure requiring admission in the hospital which would be valid for 3 months.
(d) In partial modification of para 3 of letter under ref 1.(a) the special provision for ECHS beneficiaries to avail Consultation/ investigations/ treatment procedures shall hereinafter apply to ECHS beneficiaries aged 70 years and above as against 75 years.
Treatment at Government Hospital (s).
(a) The term “Government hospital” would include all AIIMSs, Institutions of National Importance (INIS), North East Institutions, Tata Memorial Hospital and all other medical institutions under Central and State government.
(b) No referral or permission shall be required for undergoing consultation investigation/ treatment procedure including unlisted investigations/ procedures.
In case of of treatment under emergency and post operative follow up treatment the instructions remain the same as per extant rules.
This has the approval of MD ECHS.
