The Ministry of Health and Family Welfare’s Directorate of CGHS has issued an office order to address the difficulties faced by CGHS beneficiaries in obtaining a referral to empanelled hospitals when they are unable to visit CGHS Wellness Centers physically.
The office order states that CGHS Medical Officers may issue referrals to empanelled hospitals for consultation/endorsement without insisting on the physical presence of the beneficiary if the request is justified based on the documents submitted through a representative.
Additionally, the Medical Officer may contact the beneficiary by video call or make a domiciliary visit if they are not satisfied with the papers submitted. The Addl. Directors of CGHS Cities/Zones are instructed to circulate the office order to CMOs In Charge and other CGHS staff to ensure the guidelines are implemented.
Referral to empanelled hospitals for consultation/endorsement
Govt. of India
Min. of Health & Family Welfare
Department of Health
Directorate of CGHS
Dated the 31st March 2023.
Subject: Referral to empanelled hospitals for consultation/endorsement – regarding
With reference to the above-mentioned subject the undersigned is directed to state that this Ministry is in receipt of representations regarding difficulties being faced by CGHS beneficiaries in obtaining referral to empanelled hospitals by CGHS, when they are not in a position to visit CGHS Wellness Centers physically. In view of the representations. as referred to, this matter has been reviewed by this Ministry and it is now decided to issue the following guidelines in this regard:
- Whenever there is a request for a referral for consultations/endorsement submitted through a representative by a CGHS beneficiary, where the beneficiary is not in a position to attend CGHS Wellness Centre physically, CGHS Medical officer, based on the documents submitted, considers that the request is justified, may issue referral to CGHS empanelled hospital for consultation/endorsement, as the case may be, without insisting on the physical presence of the concerned CGHS beneficiary.
- If CGHS Medical Officer is not satisfied with the papers submitted through the representative, he/she may avail the option of contacting the CGHS beneficiary by video call or making a domiciliary visit to satisfy the requirement of referral/endorsement and shall not insist on the physical presence of such CGHS beneficiary.
- Addl. Directors, CGHS of Cities/Zones shall circulate a copy of this Office Order to CMOs In Charge and other CGHS Staff to take necessary action and to monitor the implementation of the guidelines.
(Dr. Manoj Jain)