ESI (MB) Scheme Primary & Secondary Service Provider

---

Cashless service means that patient will not have to spend any amount for taking the treatment and hospitalization. 

You do not have to worry about finances in case of a hospitalization, thus giving you peace of mind.

Jeevan Rekha Hospital is a Primary as well as a Secondary Service provider accredited by ESI (MB) Scheme of West Bengal. All speciality & Superspeciality treatment modalities under Medical management and Surgical Intervention are available at our hospital.

You can search for facilities available in the hospital through our website www.jeevanrekhahospital.com

Jeevan Rekha Hospital is a Primary as well as a Secondary Service provider accredited by ESI (MB) Scheme of West Bengal. 

Under the Primary tie-up of the ESI (MB) Scheme, beneficiaries are eligible for free dispensary (OPD) & Medicines from our hospital.

Jeevan Rekha Hospital is a Primary as well as a Secondary Service provider accredited by ESI (MB) Scheme of West Bengal. 

Under the Secondary tie-up of the ESI (MB) Scheme beneficiaries are eligible for Cashless Admission & Hospitalization in our hospital.

Primary OPD treatment at Dispensary unit of the Hospital is free of charge. Specialist & Superspecialist OPD does not fall under this scheme.

All employees working and earning up to Rs. 21,000 per month are eligible for the ESIC scheme. This includes all sorts of workers: permanent, temporary, and contractual workers. All establishments having 10 or more employees need to register themselves with the ESIC scheme.

The scheme applies to all types of employment businesses. Employees who are covered under other health insurance schemes or any government-funded health insurance schemes are not eligible for the ESIC scheme. There is also a regulation for voluntary coverage to cover employees who are not eligible for mandatory coverage under the ESIC scheme.

Cashless inpatient treatment services are accessible to all eligible ESI beneficiaries, eliminating the necessity for them to make hospitalization payments. 

The scheme excludes cosmetic surgeries and non-medical treatments. Apart from these, major treatments are covered in a cashless manner in empanelled hospitals.

Non-Medical:

• ESIC Pehchan Card duly attested by the Employer.
• Government issued Identity proof of Employee and their dependents (like Voter’s ID card, Aadhar Card, Driving License)

Medical:

• Previous Medical Documents (if any)
• Doctor’s Prescription (if any)
• Past Investigation reports (if any)

• Arrive at the ESI Desk at First Floor & submit the ESIC Pehchan Card or Insurance number of the employee and their dependents.
• Get yourself examined by the Medical Officer at the free ESI Dispensary.
• Bring documents like - ESIC Pehchan Card duly attested by the employer, Government issued Identity proof of Employee and their dependents (like Voter’s ID card, Aadhar Card, Driving License), Doctor’s prescription, and relevant supporting reports.
• Hospital pharmacy will dispense the medicines prescribed free of charge.

If a particular medicine is not available under the ESI Medicines, beneficiary has to pay the full price for the medicine which can be reimbursed by the beneficiary from the ESI Cell directly.

In case of Planned Admission:

• Arrive at the ESI Desk at First Floor & submit the ESIC Pehchan Card or Insurance number of the employee and their dependents.
• Get yourself examined by the Medical Officer at the free ESI Dispensary.
• Bring documents like - ESIC Pehchan Card duly attested by the employer, Government issued Identity proof of Employee and their dependents (like Voter’s ID card, Aadhar Card, Driving License), Doctor’s prescription, and relevant supporting reports.
• Hospital will send an authorisation request to the ESI Cell.
• ESI Cell will check the details and approve the request.
• Post the treatment, HCO or the hospital will send the bill to the ESI Cell. The bill shall be accompanied by required documents like a medical report, doctor’s certificate, discharge summary, etc.
• ESI Cell will verify the sent documents & approve the claim.

In case of Emergency Admission:

If you are in need of urgent admission, get admitted in the hospital & then approach the First Floor ESI Desk within 24 hours of admission with all requisite documents.

ESIC Pehchan Card is essential to get the service. If card is not available, contact ESI desk.

At Jeevan Rekha Hospital, Specialist Doctors are available across various facilities who attends to patients immediately after Planned or Emergency admissions like Heart Attack, Brain stroke, Burns, Accidents etc.

In the event of non-critical treatment, you will have access to the General Ward. However, for critical cases, you will receive treatment in the ICU or HDU as determined by the medical team's assessment and requirements. 

Yes, a request for authorization for ESI may be declined if,

• Inadequate/wrong information is provided and the ESI department is unable to get access to additional information.
• The ailment/disease for which hospitalization/surgery is required is not covered by the policy.
• The person does not have adequate insured amount in the ESI account left to cover the hospitalization costs.

This only means that cashless access is declined, AND IS IN NO WAY TO BE CONSTRUED AS DENIAL OF TREATMENT. The beneficiary must obtain the treatment as per his/her treating doctor’s advice & settle all the Hospital Bills at the time of discharge through Cash & later apply for reimbursement.

All bills in original and discharge certificate are to be left with the ESI Desk at Jeevan Rekha Hospital providing cashless treatment. The patient has to countersign all bills and fill the claim form and also leave the same with the hospital at the time of discharge.

A copy of the Discharge Summary & Medical Reports can be carried by you for your records.