Vinita Singh PPT

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Transcript of Vinita Singh PPT

  • Bhamashah Swasthaya Bima YojanaRajasthan

  • Bhamasha Swasthaya Bima YojanaLaunched on 13th December, 2015 for around 1 crore eligible families of Rajasthan in compliance of Budget Declaration of Honble Chief Minister, Rajasthan.

  • Organogram-State Level

  • Organogram-District Level

    *

  • Bhamasha Swasthaya Bima YojanaBeneficiary: Families identified under National Food Security Act (NFSA) and Rashtriya Swasthya Bima Yojana (RSBY).

    Health Insurance Coverage: Rs. 30,000 (for general illnesses) and Rs. 3.00 lacs (for critical illnesses) per family per year.Disease Coverage: Total 1715 disease packages 1148 Secondary 500 Tertiary 67 Govt. reserved packagesCovering 14 specialties.

  • Secondary Packages (1148)Tertiary Package (500)Government PKg (67)

    SpecialtyNo. of PkgDentistry36ENT155General Medicine36General Surgery402Neurosurgery59Obstertics & Gynaecology93Oncology10Ophthalmology64Orthopedics202Paediatrics31Urology124

    SpecialtyNo. of PkgCardiology & CTVS122Chest Surgery20ENT2General Medicine16General Surgery21Neurosurgery64Oncology178Orthopedics10Paediatrics8Plastic Surgery13Urology46

    SpecialtyNo. of PkgENT14General Surgery18Obstertics & Gynaecology25Ophthalmology10

  • ContinueGovt Hospitals (n=480): Medical College & associated hospitals, DH, SDH, Satellite hospitals and CHCsPrivate Hospitals (n=568) empanelled under the scheme, Empanelment of Pvt hospitals is responsibility of Insurance Company.

    Information on govt and empanelled private hospitals is available at webpage of scheme http://health.rajasthan.gov.in/bsby

  • No. of Private Hospitals Empanelled So FarIncreasing number of hospitals depicts increasing interest of private sector

    Chart1

    167

    189

    202

    320

    358

    453

    498

    545

    568

    Series 1

    Sheet1

    Series 1Series 2Series 3

    14-12-151672.42

    18-12-151894.42

    29-12-152021.83

    25-01-163202.85

    17-02-16358

    17-03-16453

    20-04-16498

    29-06-16545

    26-07-16568

  • Stakeholders in the Scheme

  • Responsibility of StakeholdersMedical & Health: Overall planning & execution of schemePayment of premium to InsurerMonitoring & Grievance Redressal of pvt & govt hospitalsNIAC:Providing Insurance Cover to entitled familiesEmpanelment of private hospitalsTraining & orientation of SM & Nodal OfficersClaim processing and paymentDoIT:Preparing software for the schemeEstablishment of Call CenterSupport in IT related issues Issuing Bhamashah Card to all.

  • Admission & TID Generation by HospitalEligibility Verification of Family and individual Identity using Bhamashah Card / Bhamashah Slip / RSBY CardChecking available amount in wallet of familyStarting Treatment

    Blocking PackageOnline Pre-Authorization Request and Approval by NIACDischarge & online claim submissionClaim Approval & Online Payment to HospitalSecondary PackageTertiary PackagePatient will be received at hospital by Swasthya Margdarshak after IPD advise by doctorProcess Flow under BSBY

  • What makes us different

    Rajasthan RSBYMaharashtraTamil Nadu Sum insuredSecondary 30,000Tertiary 3,00,00030,0002,50,0001,50,000Coverage ComprehensiveSecondary and TertiarySecondaryTertiary Tertiary Target populationNFSA (includes 15 categories) and RSBY BPL familiesBPL & APL families BPL familiesPackages 171513009721016Verification of beneficiaryBhamashah CardBiometricYellow / Orange cardBiometricMultipurpose call centerYesNoNoNo

  • Progress So Far..

  • Total No. of Claims Enlisted

    Chart1

    3228

    20063

    52906

    97800

    154178

    228800

    300751

    364187

    386433

    Total Claims Booked

    Number of Claims

    Sheet1

    Column1Total Claims Booked

    31-12-20153228

    31-01-201620063

    29-02-201652906

    31-03-201697800

    30-04-2016154178

    31-05-2016228800

    30-06-2016300751

    31-07-2016364187

    10/8/16386433

    *

  • Total Amount of Enlisted Claims (Rs. in Lac)

    Chart1

    164.23

    1016.43

    2742.05

    4873.94

    7397.41

    10736.41

    14045.47

    17069.84

    18177.17

    Total Claims Booked

    Rs. In Lac

    Sheet1

    Column1Total Claims Booked

    31-12-2015164.23

    31-01-20161016.43

    29-02-20162742.05

    31-03-20164873.94

    30-04-20167397.41

    31-05-201610736.41

    30-06-201614045.47

    31-07-201617069.84

    10/8/1618177.17

  • Total No. of Claims Submitted

    Chart1

    2611

    16590

    44319

    83406

    132820

    197070

    261073

    313893

    335992

    Total Claims Booked

    Number of Claims

    Sheet1

    Column1Total Claims Booked

    31-12-20152611

    31-01-201616590

    29-02-201644319

    31-03-201683406

    30-04-2016132820

    31-05-2016197070

    30-06-2016261073

    31-07-2016313893

    10/8/16335992

  • Total Amount Submitted (Rs. in Lac)

    Chart1

    124.9

    769.55

    2135.56

    3888.84

    6086.3

    8903.33

    11771.29

    14112.3

    15192.39

    Total Claims Booked

    Rs. In Lac

    Sheet1

    Column1Total Claims Booked

    31-12-2015124.9

    31-01-2016769.55

    29-02-20162135.56

    31-03-20163888.84

    30-04-20166086.3

    31-05-20168903.33

    30-06-201611771.29

    31-07-201614112.3

    10/8/1615192.39

  • Total No. of Claims ApprovedClaim approvals raised by around 86,000 in last two months

    Chart1

    1736

    12142

    31221

    57384

    89043

    130702

    177485

    216938

    239524

    Total Claims Booked

    Number of Claims

    Sheet1

    Column1Total Claims Booked

    31-12-20151736

    31-01-201612142

    29-02-201631221

    31-03-201657384

    30-04-201689043

    31-05-2016130702

    30-06-2016177485

    31-07-2016216938

    10/8/16239524

  • Total Claims Approved (Rs. in Lac)Approvals raised by around 40.00 cr in only two months

    Chart1

    73.75

    493.74

    1419.89

    2520.02

    3693.65

    5194.58

    7196.23

    9015.43

    10270.27

    Total Claims Booked

    Rs. In Lac

    Sheet1

    Column1Total Claims Booked

    31-12-201573.75

    31-01-2016493.74

    29-02-20161419.89

    31-03-20162520.02

    30-04-20163693.65

    31-05-20165194.58

    30-06-20167196.23

    31-07-20169015.43

    10/8/1610270.27

  • Total No. of Claims PaidRise of approximately 1,25,000 claims in last two months

    Chart1

    15979

    22042

    34580

    83639

    142605

    209558

    Series 1

    Number of Claims

    Sheet1

    Series 1Series 2Series 3

    till 29th Feb, 2016159792.42

    31-03-2016220424.42

    30-04-2016345801.83

    31-05-2016836392.85

    30-06-2016142605

    28-07-2016209558

    To resize chart data range, drag lower right corner of range.

    The data is taken from the email received from Sh Lalit Jain, NIAC*

  • Total Amount Paid (Rs. in Lac)Rise of 51 crores in last two months

    Chart1

    338.26485

    678.35097

    1303.52985

    3098.67

    5260

    8117.47

    Amount

    Rs. In Lac

    Sheet1

    AmountSeries 2Series 3

    till 29th Feb, 2016338.262.42

    31-03-2016678.354.42

    30-04-20161303.531.83

    31-05-20163098.672.85

    30-06-20165260.00

    28-07-20168117.47

    To resize chart data range, drag lower right corner of range.

    The data is taken from email received from Sh. Lalit Jain, NIAC*

  • Pvt Contribution in Total Claim Booking

  • Critical Diseases Treated under The Scheme

    Cardiovascular & Cardio Thoracic and Vascular Surgery: Bypass surgery (CABG): 305 claims amounting Rs. 2.27 croreHeart Valve Repair: 512 claims amounting Rs. 5.43 crore. Angioplasty: 2135 claims worth of Rs. 11.61 crore. Congenital Heart Disease:102 claims amounting Rs. 67.44 lac. Cancer: 11602 claims of cancer treatment (Chemotherapy, Radiotherapy and Surgery) amounting Rs. 14.96 crore. Brain Surgery: 1112 claims amounting Rs. 3.26 crore. Spinal Surgery: 796 claims amounting Rs. 2.41 crore.Lung Surgery: 75 claims amounting Rs. 24.08 lac rupees.Plastic Surgery: 233 claims amounting Rs. 81.67 lac.

  • IEC Activities

  • BSBYLED BOARD ON TOP OF PVT HOSPITALS

  • LED Boards on Roads

  • Pamphlet Printed for IEC of the Scheme & Pvt. Empanelled Hospitals

    *

  • Facebook page- regular updation

  • Regular Updates on Google+ and blog

  • Success Stories of BSBY across Districts

  • ASHA Samwad with more than 46,000 ASHAs through Video Conference under the chairmanship of Honble Health Minister, GoRThree rounds accomplished so far for orientation regarding BSBY

    Video Conferences with ASHA

  • BSBY ASHA KIT

    *

  • IEC of BSBY Through Auto Riksha

    *

  • Bhamashah Samsya Samadhan Shivir Extensive IEC of the BSBY in Bhamashah Samsya Samadhan Shivir being held during 25th July, 2016 to 5th August, 2016 at each panchayat HQ.

  • Official Webpage of BSBY

  • Grievance Redressal

  • Redressal of Grievances State (SGRC) and District Grievance Redressal Committees (DGRC) are formulated. SGRC: under the Chairmanship of CEO, RSHAADGRC: under the Chairmanship of District CollectorFormulation of State Appellate Authority under the chairmanship of Principal Secretary, M&HRajasthan Sampark Portal: Public grievance portal for inhabitants of state, can also register their complain at this portal.Integrated Toll Free Centre: 1800-180-61