Health Scheme

Online permission for treatment in Health Scheme

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Medical Cell of West Bengal Finance Department introduced functionality of online permission for treatment in Entitled Hospital outside the State through West Bengal Health Scheme Portal. View the full Government Order with annexure I describing complete process flow.

Summery of the Order:

Order No.3-F (MED) WB
Date17th Jan, 2022
Published byMedical Cell of Finance department of West Bengal
SubjectIntroduction of online permission for treatment in Health Scheme Portal
Online permission for treatment in Health Scheme

View Order for online permission for treatment in Health Scheme:

Government of West Bengal
Finance Department
Medical Cell, Writers’ Building

No. 3-F (MED) WB

Dated: 17.01.2022

ORDER

Sub: Introduction of online functionality for seeking prior permission of availing treatment in Enlisted Hospitals outside the State through West Bengal Health Scheme Portal.

At Present, the enrolled employee/pensioner of WBHS has to submit their manual application seeking prior permission to avail urgent treatment in enlisted hospitals outside West Bengal to their respective head of the Administrative Department through proper channel in terms of Notification Nos.7287-F, dated 19.09.2008 read with 9205-F (MED) WB dated 05.10.2009, 3731-F (MED) WB dated 10.05.2013 and 74-F (MED) WB dated 21.08.2018 issued from Medical Cell, Finance Department, Govt. of West Bengal.

In manual mode, it has been observed that huge time is taken at different stages of processing such application for urgent treatment outside the State. In order to handle such applications faster, transparently and to reduce the pain & anxiety of the beneficiary in this regard, introduction of online application seeking prior permission of availing urgent treatment in enlisted hospitals outside the State was under active consideration of this department for some time past.

Now, after careful consideration, the Governor is pleased to implement ONLINE processing of application seeking prior permission for availing treatment in enlisted hospitals outside the State through the WBHS Portal. Details of process flow of such online processing of permission cases are mentioned in Appendix-I.

This online functionality for seeking prior permission for availing treatment outside the State will come into effect from 01.02.2022.

This has the approval of Principal Secretary, Finance Department, Govt. of West Bengal.

Enclosure: Appendix-I

ALOKE KUMAR MUKHERJEE, WBA & AS
Joint Secretary, Finance Department
Government of West Bengal

West Bengal Health Scheme

Appendix-I


(As per Order No.3-F(MED)WB, dated 17.01.2022)

(Process flow for seeking prior permission for availing treatment in enlisted hospitals outside West Bengal through WBHS Portal)

  1. All enrolled employees/pensioners (including family pensioners) will have to apply using his/her personal login in WBHS Portal. Detailed process for creating personal login in WBHS Portal is stated in Notification Nos. 127-F(MED)WB dated 26.11.2021 issued by Medical Cell, Finance Department, Govt. of West Bengal.
  2. At the time of online application, concerned employee/pensioner has to incorporate some basic information. Moreover s/he has to upload a single pdf file (maximum size 2mb) mandatorily attaching the following documents:
Sl. No.Name of the enlisted Hospital outside West Bengal for which permission is to be sought under WBHSMandatory documents to be attached (in chronological order)
For first case of seeking permission:
1Tata Memorial Hospital, Mumbai.1. OPD prescription from Treating Consultant of Recognized/Empanelled Private Hospitals
within West Bengal.
2. Copy of malignant confirmatory Biopsy Report.
2Other Enlisted Hospitals outside West Bengal.1. OPD prescription from Treating Consultant of Recognized/Empanelled Private Hospitals within West Bengal.
2. Copy of major investigations (done by MRI/CT/Ultrasound/Endoscopic method).
3. Copy of Referral from a Treating Consultant of Recognized/Empanelled Private Hospitals within West Bengal.
For follow up/subsequent case of seeking permission:
3 Tata Memorial Hospital, Mumbai.1. Copy of order for previous permission.
2. Copy of OPD prescription or Discharge Summary from Enlisted Hospitals outside West Bengal where treated.
4 Other Enlisted Hospitals outside West Bengal. 1. Copy of order for previous permission.
2. Copy of OPD prescription or Discharge Summary from Enlisted Hospitals outside West Bengal where treated.
  1. After successful incorporation of all and documentation as above, s/he has to submit the application electronically.
  2. After online submission, employee/pensioner will take a print out of system generated application. Then s/he will sign in the appropriate space provided therein. Then s/he will attach all necessary enclosures chronologically mentioned in the last part of the application form. Finally s/he will submit signed copy of such application physically to the office of the Head of Office/Pension Sanctioning Authority (HoO/PSA) at the earliest for taking necessary action from their end.
  3. Scope for editing of incorporated information against an application is not possible after, once it is submitted.
  1. On receiving physical copy of application enclosed with all essential documents, respective Operator (Reimbursement) shall carefully scrutinize it physically and electronically to determine the essentiality as per guidelines of WBHS. After determining essentiality, s/he will forward the application physically as well as electronically by selecting the level of same or immediate higher authority for further scrutiny including his/her specific notes (mandatory),If there is any discrepancy, s/he may raise objection and return the same to the applicant for compliance.
  2. After getting the application electronically and physically from a same or subordinate level, intermediary level [i.e. Recommending Authority (Reimbursement) or Delegated Approver (Reimbursement) if created] will check and verify it again. After satisfying himself/herself, s/he will forward it with mandatory notes to another user of same or next level of user i.e. HoO/PSA .As like Operator (Reimbursement), user of this level may also raise objection if s/he finds any discrepancy while checking for getting necessary compliance it from the end of the applicant.
  3. HoO/PSA shall verify it again. In case of discrepancy, s/he may also raise objection or send back subordinate users of his/her office for necessary compliance. On satisfying himself/herself about essentiality, HoO/PSA shall forward electronically (not physically) only to the controlling Administrative Department of concerned applicant by selecting the name of Operator (Reimbursement) of that office.
  4. As like users of subordinate offices, Operator (Reimbursement) or Recommending Authority (Reimbursement) of Administrative Department will check the application carefully and will forward the case to Delegated Approver (Reimbursement) of the Administrative Department for taking necessary action.
  5. After getting it from subordinate user, Delegated Approver(Reimbursement) of Administrative Department will check the essentiality again and take action accordingly as mentioned below:-

I. In case of first time permission seeking for availing treatment in Tata Memorial Hospital, Mumbai, All India Institute of Medical Science, New Delhi and NIMHANS, Bangaluru, it would be forwarded to the Departmental Head of the Administrative Department for final approval/rejection of prior permission.

II. In case of first time permission seeking for availing treatment in rest of enlisted hospitals outside West Bengal, it should be forwarded to Medical Cell, Finance Department mandatorily for consultation with the West Bengal Health Scheme Authority (WBHSA) before sending to the Departmental Head of the Administrative Department for final approval/rejection of prior permission.

III. In case of follow up or subsequent permission seeking for availing treatment in all enlisted hospitals outside West Bengal, it would be forwarded to Departmental Head of the Administrative Department for final approval/rejection.

  1. At final stage, Departmental Head of the Administrative Department will approve/reject it. DSC registration of the Departmental Head is not required for approval/rejection. But registration of DSC from the end of Departmental Head or Delegated Approver (Reimbursement) is mandatory for generation of approval/rejection order.
  2. Once approval/rejection order is generated in WBHS Portal, it will be available for preview and print in the login of all stakeholders like employee/pensioner, Operator (Reimbursement), HoO/PSA, Drawing and Disbursing Officer (DDO) and Pay & Accounts Officer/Treasury Officer.

ALOKE KUMAR MUKHERJEE, WBA & AS
Joint Secretary, Finance Department
Government of West Bengal

Download No. 3-F (MED) WB, Source

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