WBHS Cashless Facility In Woodburn Ward, IPGME&R-SSKM Hospital

Employees, pensioners, and their families who are beneficiaries of the West Bengal Health Scheme (WBHS) will now have access to cashless treatment at the IPGME&R-SSKM Hospital, Kolkata in the Woodburn Ward. This new facility is effective from the date of issuance of the order and will remain valid until March 31, 2027, unless further orders are issued.

Beneficiaries of Cashless Facility

Employees, pensioners, and family pensioners of the Government of West Bengal.
AIS Officers and pensioners who served the State Affairs of West Bengal.

Also Read: WBHS Cashless Limit Increased

WBHS Cashless Facility At SSKM

Location: Woodburn Ward, IPGME&R-SSKM Hospital, Kolkata.
Mode: Cashless treatment up to Rs. 2 lakh per treatment.
Excess Charges: If treatment costs exceed Rs. 2 lakh, the additional amount must be paid by the beneficiary.

Hospital Classification and Tariff

Classification: IPGME&R-SSKM Hospital, Kolkata, is classified as a Special Category Government Hospital with code 0110001.
Tariff: 100% of the tariff as mentioned in Annexure-I for treatments in Woodburn Ward.

Bed Accommodation

Single Occupancy Large Cabin: Rs. 4000/-
Single Occupancy Small Cabin: Rs. 2500/-
Double Occupancy Large Cabin: Rs. 2000/-
Entitlement: Beneficiaries will avail bed accommodation as per their entitlement stated in their WBHS Enrolment Certificate.
Special Cases: ICU/ITU, Day Care, HDU, and Isolation Beds are available to all beneficiaries irrespective of bed entitlement.

Medicine Supply

Provision: Hospital will provide all medicines for treatment and not direct patients to purchase separately.
Exception: In case of non-availability of high-value drugs, patients may provide them with proper requisition and approval, and this will be recorded for reimbursement.

Treatment Costs and Reimbursement

Cost over Rs. 5 lakh: If treatment exceeds Rs. 5 lakh, the hospital must notify the WBHSA with a prognosis report and detailed bill for permission to continue treatment.
Diet and Personal Attendant: Not included in bed rent; diet costs Rs. 336/day and attendant charges Rs. 750/day.
Special Treatments: Prior permission needed for cancer chemotherapy/immunotherapy costs exceeding Rs. 50,000 per cycle.

Inadmissible Components and Disposables

The ceiling for disposables/consumables is not applicable for treatments in Woodburn Ward.
Recovery of Costs: The hospital may recover the cost of inadmissible components from the beneficiary at discharge, as per Order No. 6580-F(MED) Dated 29/06/2019.

Death of a Patient

Immediate Release: The hospital will release the dead body immediately.
Outstanding Dues: Unsettled dues will be billed to the Medical Cell of the Finance Department for settlement.

Estimate of Expected Bill Under Cashless Facility in SSKM

On Admission: A written estimate will be provided if the total expenditure exceeds Rs. 2 lakh.
Changes in Estimate: Any changes in the estimate must be communicated within 48 hours.

Validity

The cashless facility in Woodburn Ward, IPGME&R-SSKM Hospital, Kolkata, is valid up to March 31, 2027.

Also Read: West Bengal Health Scheme Cashless Hospital List

Official Order

Government of West Bengal
Medical Cell, Finance Department
2.4 Floor, Old Khadya Bhavan
11A, Mirza Ghalib Street, Kolkata-700087

No.187- F(MED)WB/FIN/827/2023 ———————————————————— Dated: 28/12/2023

NOTIFICATION

Sub: Introduction of Cashless facility in Woodburn Ward, IPGME&R-SSKM
Hospital, Kolkata under West Bengal Health Scheme.

Employees/Pensioners/Family Pensioners of Government of West Bengal and AIS Officers and Pensioners who renders /rendered service to the State Affairs of West Bengal now get medical treatment facility under West Bengal Health Scheme (WBHS).

Beneficiaries of WBHS avail treatment at Hospitals under the management of the Govt of West Bengal in reimbursement mode and get such treatment cost from their respective offices.

IPGME&R-SSKM Hospital, Kolkata has expressed their interest to provide cashless treatment facility in Woodburn Ward to the beneficiaries of WBHS as per Tariff enclosed with Annexure-I.

After careful consideration, the Governor is pleased to accept the proposal of the Hospital for introducing the cashless treatment in Woodburn Ward of IPGME&RSSKM Hospital, Kolkata with the following terms and conditions: –

IPGME&R-SSKM Hospital, Kolkata shall be treated as a Special Category of Govt Hospital. Code of the Hospital will be 0110001.
IPGME&R-SSKM Hospital, Kolkata shall charge 100% Tariff as mentioned at Annexure-I for treatment of the beneficiaries under the West Bengal Health Scheme in Woodburn Ward.
Beneficiaries under the West Bengal Health Scheme may avail In-Patient Department (IPD) treatment in Woodburn Ward of IPGME&R-SSKM Hospital, Kolkata. Hospital shall provide IPD treatment in cashless mode upto Rs 2(two) lakh in each treatment. Where charges for treatment as per existing approved rate exceed rupees two lakh, the amount over and above two lakh would be realized from the beneficiary.
There are three types of Bed accommodation namely(i) Single Occupancy Large Cabin ( Rs 4000/-) (ii) Single Occupancy Small Cabin ( Rs.2500/-) and (iii) Double Occupancy Large Cabin ( Rs.2000/-) in Woodburn Ward, IPGME&RSSKM Hospital , Kolkata for availing indoor treatment of the beneficiaries of WBHS.
Beneficiaries shall avail bed accommodation according to entitlement stated in the Enrolment Certificate. But, other critical category of beds like ICU/ITU, Day Care (Minimum 4 hours duration) HDU etc. along with Isolation Bed will be applicable for IPD treatment of all beneficiaries irrespective of their bed entitlement.
The IPGME&R -SSKM Hospital, Kolkata shall supply all medicines for treatment of the beneficiaries in Woodburn Ward and not to direct the patient or their relatives to purchase any medicines separately during ongoing IPD treatment of the beneficiary under WBHS. But, in case of non-availability of high value drugs at the store of hospital, the patient /relatives of the patient may supply such drugs to the hospital as per proper requisition and approval of the treating consultant. The hospital authority has to acknowledge such arrangement of drugs and to record the same in the Form-D4 so that beneficiary can get reimbursement of it under WBHS.
IPGME&R -SSKM Hospital, Kolkata shall provide suitable accommodation (Cabin) in Woodburn Ward to the IPD patients as per their entitlement mentioned in their Enrolment Certificate. If hospital provides higher category of bed as per choice of the patient, employee/pensioner will have to bear the excess amount over entitlement and hospital shall recover the same from the patient at the time of discharge. Such excess amount paid by the patient will not be reimbursable under WBHS.
In case of IPD treatment cost exceeds Rs 5 (five) lakh, the matter is to be brought to the notice of the West Bengal Health Scheme Authority (WBHSA) by the IPGME&R -SSKM Hospital, Kolkata with prognosis report of the patient as to whether it is limited/ nil/poor/guarded issued by the treating consultant attaching up-to-date detailed bill for prior permission of the WBHSA for continuing further treatment.
The personal attendant (Aaya) charges and cost of diet are not included in the bed rent. The cost of diet & personal attendant (Aaya) charges are fixed at Rs.336/day and Rs. 750/day respectively which will be included in the Final bill.
In case of cancer chemotherapy /immunotherapy, prior permission is to be obtained from WBHSA through WBHS portal whenever the cost of therapy per cycle exceeds Rs. 50,000/- (Rupees fifty thousand) only in each case. A justification from the treating oncologist is to be furnished at the time of seeking permission for administering of such drugs with regard to the expected prognosis of the patient clearly mentioning survival /palliation.
The ceiling of disposables/consumables mentioned in Clause 9 order No. 11253-F(MED) Dated 16/12/2011 shall not be applicable for the treatment of the beneficiaries of WBHS in WoodBurn Ward, IPGME&R -SSKM Hospital, Kolkata. Hospital may use all such consumables based on necessity and charge it as admissible items.
Hospital will have the full right to recover the cost of inadmissible components under WBHS as per Order No. 6580-F(MED) Dated 29/06/2019 except those components mentioned in the serial No. B from the employee/pensioner /family pensioner or from their dependents at the time of discharge from hospital.
Hospital shall release the dead body of employee/pensioner /family pensioner immediately in case of death while availing indoor treatment. If the hospital dues remain unsettled partially or fully, hospital authority will send the entire bills with necessary documents directly to the Medical Cell of Finance Department for clearance of their dues. The Medical Cell shall scrutinize the claim and calculate the admissible amount as per provision and refer the same to the concerned Administrative Department of the beneficiary for final settlement of the claims from their end in favour of the Hospital and the legal claimant of patient.
In case of death of the patient, D4 should be signed by dependent beneficiary of WBHS/family member/close relative of the deceased.
On admission of the beneficiary, a written estimate of the expected bill shall be handed over to patient /relative of patient in case the total expenditure exceeds Rupees two lakh. Whenever there is a change in escalation of this estimate, a fresh estimate shall be given to the patient /relative of patient within 48 hour from the admission.
This facility in Woodburn Ward IPGME&R – SSKM Hospital, Kolkata will remain valid upto 31/03/2027 until further order.
Cashless facility will be available for IPD treatment in Woodburn Ward, under IPGME&R -SSKM Hospital, Kolkata with effect from the date of issuance of the order.

Enclo: Approved Tariff List (Annexure-])

By order of the Governor
SD/-
K. A. Anwar, IAS)
Senior Special Secretary
to the Government of West Bengal

Official Source: Click Here

Also Read: West Bengal Health Scheme Cashless Hospital List
                  WBHS New Cashless Limit

Frequently Asked Questions

Who are the beneficiaries eligible to avail cashless facility medical treatment under the West Bengal Health Scheme at IPGME&R-SSKM Hospital, Kolkata?

Employees, pensioners, family pensioners of the Government of West Bengal, AIS (All India Services) officers, and pensioners who have served or are serving the State Affairs of West Bengal.

What does the term “cashless facility” mean in the context of this order?

Cashless treatment means that beneficiaries can receive medical treatment at IPGME&R-SSKM Hospital without paying upfront up to Rs. 2lakh.

What are the criteria for availing cashless facility In-Patient Department (IPD) treatment in the Woodburn Ward of IPGME&R-SSKM Hospital under WBHS?

Beneficiaries can avail cashless IPD treatment up to Rs. 2 lakh per treatment episode. Beyond this limit, the excess amount is to be paid by the beneficiary.

Under what circumstances might a beneficiary have to pay for treatment costs exceeding Rs. 2 lakh during their IPD treatment?

If the treatment costs exceed Rs. 2 lakh, the beneficiary is responsible for paying the excess amount at the time of discharge.

Also Read: West Bengal Health Scheme Cashless Hospital List
                  WBHS New Cashless Limit