The eligibility of the hospitals for empanelment with the Trust under the scheme is given below.
i. Bed Strength: A hospital intending to empanel is required to have a minimum 50 beds and it shall apply for at least two specialties.
ii. Govt. vide G.O.Ms.No.162 HM&FW (K1) Dept. dated.23.05.2005 has issued orders that single specialty Ophthalmology hospitals bed strength is reduced to 20 for empanelment.
iii. Statutory Requirements: The hospital shall have got registered Certificate under APAPMCE(R&R) Act 2002. A hospital intending to empanel is required to have an Outpatient Department, Inpatient Department, Operation Theatre, Specialty Care Units –Intensive care units & Post-operative wards, Specialty specific care units, Emergency and Accident Department/ Casualty, Central Sterilization and Supply Department, Medical Records Department. All the Essential drugs should be available in the Pharmacy round the clock. Adequate number of nursing staff, helpers, administrative and maintenance staff are mandatory.
Know the Network hospitals in
1. Andhra Pradesh
2. Telangana
3. Karnataka
4.Tamlnadu
Open this link : https://teluguenews.com/Hospitals.aspx
The State Government of Andhra Pradesh has formulated a health scheme for its serving/retired employees and their dependent family members to avail cashless treatment at several empanelled hospitals across the state. The scheme replaces the current medical reimbursement facility and boasts of new features such as treatment of chronic diseases and post-hospitalisation care. Read on to know about the Government of Andhra Pradesh’s Employee Health Scheme eligibility, coverage and benefits.
What is Employee Health Scheme (EHS – YSRAHCT)?
With the primary objective of providing health care for all and high-quality medical services to State Government Employees, the Dr YSR Aarogyasri Health Care Trust under supervision of the Government of Andhra Pradesh will implement the Employee Health Scheme (EHS). The scheme covers Andhra Pradesh government employees, pensioners and their dependent family members who can avail cashless treatment at empanelled hospitals or Network Hospitals (NWH).
It replaces the current medical reimbursement process and beneficiaries can avail new features such as post-hospitalisation medical care and treatment of chronic diseases. Beneficiaries include serving and retired employees of the state government of Andhra Pradesh.
Step-by-Step Employee Login Instructions:
The State Government has directed all DDOs in Andhra Pradesh to collect the data of all state government employees online through web-based applications in order to implement the scheme and issue Health Cards. Sometimes there may be a situation wherein the employee needs to edit or correct or update information about them or their family members. In such instances, follow the procedure below:
Step 1: Visit EHS Web Portal and log in using Employee ID as User ID, and the same User ID as a first-time password.
Step 2: You will be able to upload photographs and update dependent family members.
Search for Employee Enrollment Status:
Below is the process to know the status of the employee enrollment status online:
Step 1: Visit the EHS portal and under the Employee category, click on ‘Search Employee Enrollment Status’.
Step 2: On the new page, enter ‘Employee Name’, Date of Birth, Name of the Department and the respective DDO and click on ‘Search’.
Step 3: If the employee is already enrolled under the scheme, then the status would reflect as the application is approved.
Step 4: In case the employee is not enrolled under the EHS, then the status will reflect as ‘Not Enrolled’.
Step 5: On the same page, you need to click on ‘Enrol’. You may be asked to enter your email ID and contact number to send the Username and Password. Click on ‘Save Details’.
Pensioners:
The State Government of Andhra Pradesh has replaced the existing Medical Reimbursement process with the Employee Health Scheme. Below is the registration process for pensioners or retired employees of the state government:
EHS Pensioners Registration Process:
Retired employees or pensioners can register to the EHS service online by following instructions before you can log in to the EHS web portal.
Instructions:
Aadhaar Card: A scan of your Aadhaar Card and ensure your photo and the Aadhaar Number is clearly visible.
Photograph: A scan of a 45mm x 35mm ICAO compliant passport size colour photograph of 200Kb size.
Disability Certificates
Spouse’s Pensioner ID/Employee ID: A scanned copy of spouse In case working in the State Government or is a Service Pensioner.
Date of Birth Certificate: A scan of the DOB Certificate of dependent family members less than 5 years of age.
Step-by-Step Pensioner Login Instructions:
With all the required documents, you need to submit the application online. Also, you can approach the STO/APPO along with the documents or can contact the association representatives. Below is the guide to submit and register for the scheme for pensioners:
Step 1: Visit the EHS Web Portal and log in with your Username and Password. If you do not have the details, contact STO/APPO or by dialling EHS Toll-Free Number 104 to know your User ID.
Step 2: Sign in with your Username and Password and read the instructions provided on the website.
Step 3: Open the Enrollment Form and fill all the details including your head of department, STO/APPO and District.
Step 4: Attach all supporting documents.
Step 5: Ensure you verify all data before submitting the application.
Step 6: Click on ‘Submit’ and take a print out of the application form.
Step 7: Sign the print out of the application form and upload the signed document back online.
Step 8: Now, take a print out of the signed application form and submit with your respective STO/APPO.
An acknowledgement through SMS or email will be sent to your registered mobile number and email address, respectively. If it is rejected due to errors, then resubmit your application with correct details.
Beneficiaries not covered:
Those who are covered under other insurance schemes such as CGHS,
ESIS, Railways, Aarogya Bhadratha of Police Department and Aarogya Sahayatha of Prohibition & Excise Department;
Law officers (Advocate General, State Prosecutors, State Counsels, Government Pleaders and Public Prosecutors);
Casual and Daily paid workers;
Biological parents if adopted parents exist;
All independent children; and
AIS officers and AIS pensioners.
Family:
The following will constitute the family:
Dependent Parents (either adoptive or biological, but not both).
One legally wedded wife in case of a male employee/ service pensioner.
Husband in case of a female employee/ service pensioner.
Wholly dependent legitimate children (including step children and adopted children); and
Dependents of family pensioners shall also be eligible as in the case of Service Pensioners.
Dependency:
In case of parents, those who are dependent on the employee for their livelihood.
In case of unemployed daughters, those who are unmarried or widowed or divorced or deserted.
In case of unemployed sons, those who are below the age of 25 years
Disabled children with a disability which renders them unfit for employment.
Authentication:
The eligible beneficiaries will be provided with health cards also called eligibility cards.
The procedure of verification of eligibility of beneficiary under the scheme shall be by online authentication of the Health Card details. The beneficiary shall provide either the eligibility card or the card number in case the card is unavailable. The staff at the kiosk in the Network Hospital shall verify the details online by accessing the database. Once the authentication is complete, the eligibility verification ends.
Penal actions:
Any irregularities or misuse committed by the beneficiaries coming to the notice of Government or Dr. YSR AHCT will entail disciplinary action as per A.P. C.S. (CCA) Rules, 1991 and may attract penal action as per law.
BENEFIT COVERAGE
In-Patient Treatment:
The scheme will provide Inpatient treatment for the listed therapies for identified diseases under all specialties in the empanelled hospitals. List of IP therapies
Package includes the following services:
End-to-end cashless service offered through a NWH from the time of reporting of a patient till ten days post discharge medication, including complications if any up to thirty (30) days post-discharge, for those patients who undergo a "listed therapy(ies);
Free OP evaluation of patients for listed therapies who may not undergo IP treatment including consultation and investigations
Follow-up Services:
Follow-up services are provided for a period of one year through fixed packages to the patients whoever requires long term follow-up therapy in order to get optimum benefit from the procedure and avoid complications. Follow-up package includes consultation, investigations, drugs etc., for one year for listed therapies. List of IP therapies
Outpatient Treatment for identified chronic diseases:
OP treatment for pre-defined long-term (chronic) diseases will be provided in notified hospitals.
Hospital Stay:
The eligibility for Slab-A (consisting of employees with Pay Grades from I to IV), and Slab B (consisting of employees with Pay Grades from V to XVII) will be semi-private ward, and for Slab- C (consisting of employees with Pay Grades from XVIII to XXXII) will be private ward.
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