Letter from MD ECHS on actions in emergency, is forwarded for your information.

  Subject: INFORMATION ON ECHS - EMERGENCIES

Dear All veterans ,

1. In an emergency, an ECHS patient can directly report to a Service Hospital / nearest Empanelled Hospital / non-Empanelled Hospital.
2. It is the responsibility of the ECHS Member to intimate to the Officer-in-Charge of the Parent Polyclinic within 48 hours of an Emergency Admission, settle the Hospital Expenses and submit re-imbursement claim at Parent Polyclinic within 30 days of discharge from the Hospital.
3. Re-imbursement will only be allowed for the ACTUAL EMERGENCY at the CGHS rates or the actual claim whichever is less irrespective of amount spent by the ECHS Member.
4. Onus of proving that the treatment was taken for an Emergent Condition lies on the ECHS Member.
5. “EMERGENCY’’ means a condition which might result into loss to life/limb If not treated timely. These conditions are as follows:-
(a) Acute Cardiac Conditions/Syndromes including Myocardial Infarction, Unstable Angina, Ventricular Arrhythmias, Paroxysmal Supraventricular Tachycardia, Cardiac Tamponade, Acute Left Ventricular Failure/Severe Congestive Cardiac Failure, Accelerated Hypertension, Complete Dissection.
(b) Vascular Catastrophes including Acute Limb Ischemia, Rupture of Aneurysms, Medical and Surgical shock and Peripheral Circulatory Failure.
(c) Cerebro-Vascular Accidents including Strokes, Neurological Emergencies including Coma, Cerebro-Meningeal Infections, Convulsions, Acute Paralysis, Acute Visual Loss.
(d) Acute Respiratory Emergencies including Respiratory Failure and Decompensate Lung Disease.
(e) Acute Abdomen including Acute Obstetrical and Gynaecological Emergencies.
(f) Life Threatening Injuries including Road Traffic Accidents, Head Injuries, Multiple Injuries, Crush Injuries and Thermal Injuries.
(g) Acute Poisoning and Snake Bite.
(h) Heat Stroke and Cold Injuries of Life Threatening Nature.
(j) Acute Renal Failure.
(k) Severe Infections leading to Life Threatening Sequelae including Septicemia, Disseminated/Military Tuberculosis.
(l) Acute endocrine emergencies including diabetic ketoacidosis.
(m) Any other condition in which delay could result in loss of life or limb. In all cases of Emergency, the onus of proof lies with the ECHS member.

6. The following documents in Original are required to be submitted along with two sets of xerox copies of the original documents at Parent Polyclinic for Verification, processing and re-imbursement :-
(a) Individual Application
(b) Emergency Information Report filed at Parent ECHS Polyclinic
(c) Copy of Smart Card
(d) Discharge Certificate
(e) Emergency Certificate from the Hospital
(f) Summary of treatment, bills in original (g) Investigation Report
(h) Contingent Bill
(j) Original Receipts as proof of payment to hospital
(k) All hospital documents should be initialled by hospital authority on each page..

Regards,
Maj Gen Ashok Kumar