The majority of the financing, about 75 percent, is provided by the Government of India GOI , while the remainder is paid by the respective state government. Beneficiaries need to pay only Rs. This amount shall be used for incurring administrative expenses under the scheme. II Selection of Insurance Company. State governments engage in a competitive public bidding process and select a public or private insurance company licensed to provide health insurance by the Insurance Regulatory Development Authority IRDA or enabled by a Central legislation.
The technical bids submitted must include a number of elements as per GOI requirements. All the bids which are technically qualified go to the financial evaluation stage. The financial bid is essentially an annual premium per enrolled household.
The insurer must agree to cover the benefit package prescribed by GOI through a cashless facility that in turn requires the use of smart cards which conform to certain specifications and must be issued to all members. Each contract is specified on the basis of an individual district in a state and the insurer agrees to set up an office in each district. While more than one insurer can operate in a particular state, only one insurer can operate in a single district at any given point in time.
RSBY provides health insurance for the enrolled BPL families from each district up to a maximum number of households based on the definition and the figures provided for each state by the union Planning Commission. Respective State Governments need to convert their existing BPL data in this format for each district and send these data to Government of India which in turn checks the compatibility of this data with the standard format.
However, state governments alone are responsible for the accuracy of their BPL lists. Preparation of BPL data in the specified format is necessary for implementing the scheme in the district. IV Enrollment of Beneficiaries. An electronic list of eligible BPL households is provided to the insurer using a pre-specified data format.
An enrollment schedule for each village, along with dates, is prepared by the insurance company with the help of the district level officials. As per the schedule, the BPL list is posted in each village at enrollment station and prominent places prior to the enrollment and the date and location of the enrolment in the village is publicized in advance.
Mobile enrollment stations are set up at local centers e. These stations are equipped by the insurer with the hardware required to collect biometric information fingerprints and photographs of the members of the household covered and a printer to print smart cards with a photo.
The smart card, along with an information pamphlet describing the scheme and the list of hospitals, is provided on the spot once the beneficiary has paid the 30 rupee fee.
The process normally takes less than ten minutes. The cards are handed over in a plastic cover. In this way, each enrollee can be tracked to a particular state government official. At the end of the each day of enrolment, the list of households which have been issued smart cards is sent to the state nodal agency.
This list of enrolled households is maintained centrally and is the basis for financial transfers from the Government of India to the state governments. RSBY has a provision whereby an insurer has to hire intermediaries e. V Empanelment of Health Care Providers. After the insurance company is selected, they need to empanel both public and private health care providers in the project and nearby districts.
The empanelment of the hospitals is done based on prescribed criteria. Empanelment of hospitals shall be done as soon as the insurer gets the contract and it can continue simultaneously with the enrollment of the beneficiaries. The insurer shall empanel enough hospitals in the district so that beneficiaries need not travel very far to get the heath care services. Effortless and step by step directions to handle the transaction process.
Highly user oriented full screen navigation windows. Yes, I am interested! Features: The Transaction System Software enables the hospital staff to perform and maintain transaction functions regarding the provision of Health Insurance facilities to BPL citizens. Transaction software enables the beneficiary to register for the treatment with simple procedures.
Facilitates the beneficiary to get cashless admission for treatment. Health Cards Get Latest Price. Health cards will play a vital role in near future since it can be used for patient identification , admissions, insurance verification, payment settlement and marketing - all while reducing administrative costs and improving the quality of service. Eagle Health Card System Features: Allows for the storage of vital patient information Provides access to a health care provider's data base using plastic cards.
Simultaneous update of patient details in the health card as well as database. Consistent, accurate and secured card management system Cost-effective and User-friendly system. Hospital Management Get Latest Price. Once the card is personalized, the same is then issued to the family by capturing the data. The entire process of one family getting enrolled, the card getting personalized and issued, takes about minutes.
In addition to providing the necessary hardware and software support for the project, GDPL also provides complete backend support by assigning dedicated software professionals round-the-clock to provide technical support if and when any issue arises in any of the Units. For this purpose, GDPL has strategically allocated trained professionals called Project Coordinators in each of the districts.
RSBY Tagline The scheme was formally launched on October 1, The objective of RSBY is to protect below poverty line BPL households from major health shocks that involve hospitalization.
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