Shillong, Sept 03: The representation made by 7 hospitals from Shillong on issues pending to their claims in the hospitals has come to the notice of the Department. An emergent meeting was held on 2nd September at 3.30 PM by the chief executive officer of MHIS.
In the meeting it was understood that most of the issues has come out of the recent glitches that has happened and continues to happen with the new transaction management software. From time to time State level grievance redress meetings continue to happen.
The recent one held was on 2nd of August 2024 even when most of the issues highlighted were resolved. However, the issues had propped up again in the last 4 weeks.
MHIS has continued to grow strong with the largest number of claims made ever in the scheme for the period of September 2023-August 2024 with over 1,53,445 claims made of a value of Rs 216 Crores. Of this, the total payments of Rs 141 Crores has been made.
After rejections, a claim of Rs.48 Crores is pending for payments. Of the pending 48 crores, Rs.18 Crores is pending for all private hospitals in the State which the insurer has approved but the payments haven’t gone through due to the technical issues. Although these matters have been taken up with National Health Authority multiple times, the matter has remained unsolved.
The CEO shall visit NHA office on the 5th of September to reiterate the the matter. Meanwhile, efforts have been made to make the payments offline like it was done during May-June when the issue had come up.
The Health Department is continuously monitoring the progress. The Department realises the financial constraints the hospitals might have faced but has already made appeal in the meeting conducted yesterday to all the hospitals to provide uninterrupted services to the people.
