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Government Schemes

We are committed in implementing all governmental schemes that cater to the health of the disadvantaged patients.

Overview

To improve access of Below Poverty Line (BPL) and Above Poverty Line (APL) families (excluding White Card Holders) to quality medical care for identified specialty services requiring hospitalization for defined surgeries and therapies or consultations through an identified Network of health care providers.

 
 

Mahatma Jyotiba Phule Jeevandayi Aarogya Yojana

Mahatma Jyotiba Phule Jeevandayi Aarogya Yojana (MJPJAY) is a Universal health care scheme run by the Government of Maharashtra for people who hold one of the 4 cards issued by the government; Antyodaya card, Annapurna card, yellow ration card or orange ration card. The scheme was first launched in July 2012 and then across the entire state in November 2013. It provides free access to medical care in government empanelled hospitals for 971 types of diseases, surgeries and therapies costing up to Rs.1,50,000 per year per family (Rs.2,50,000 only for renal transplant).

We are enrolled under this scheme for various procedures done at the hospital. Aarogyamitras are posted at the hospital who help the patients in educating them regarding the scheme and we have our dedicated staff who help in processing the documents.

The Arogyamitras are available in the hospital from:
Monday to Saturday at 8.00 a.m. to 8.00 p.m.
Sunday 9.30 a.m. to 6.00 p.m

Contact Number: +91 82750 89857

We also do health camps in and around Mumbai as per the MJPJAY scheme on monthly basis.

 

Guidelines


STEP 1: Beneficiary families shall approach the Hospital. Arogyamitra placed in the hospitals shall facilitate the beneficiary.

STEP 2: The Arogyamitra at the Hospital will examine the referral card and health card or Yellow/Orange Ration Card, Annapurna or Antyodaya card register the patients and facilitate the beneficiary to undergo specialist consultation, preliminary diagnosis, basic tests and admission process. The information like admission notes, test done will be captured in the dedicated database by the Medical Coordinator of the Network Hospital as per the requirement of the Mahatma Jyotiba Phule Jeevandayi Aarogya Yojana Society.

STEP 3: The Network Hospital, based on the diagnosis, admits the patient and sends E-preauthorization request to the insurer, same can be reviewed by Mahatma Jyotiba Phule Jeevandayi Aarogya Yojana Society.

STEP 4: Recognized Medical Specialists of the Insurer and Mahatma Jyotiba Phule Jeevandayi Aarogya Yojana Society examine the preauthorization request and approve preauthorization, if, all the conditions are satisfied. This will be done within 24 working hours and immediately in case of emergency wherein e-preauthorization is marked as “EM”. The validity of preauthorization would be for 7 days.

STEP 5: The Network Hospital extends cashless treatment and surgery to the beneficiary. The Postoperative notes of the Hospitals will be updated on the website by the medical coordinator of the Hospital.

STEP 6: Hospital after performing the covered surgery/ therapy/ procedure forwards the Originals bills, Diagnostics reports, Case sheet, and Satisfaction letter from patient, Discharge Summary duly signed by the doctor, acknowledgement of payments of transportation cost and other relevant documents to Insurer for settlement of the claim. The Discharge Summary and follow-up details will be part of the Mahatma Jyotiba Phule Jeevandayi Aarogya Yojana Society portal.

STEP 7: Insurer scrutinizes the bills and gives approval for the sanction of the bill and shall make the payment within agreed period as per agreed package rates. The claim settlement module along with electronic clearance and payment gateway will be part of the workflow in Mahatma Jyotiba Phule Jeevandayi Aarogya Yojana Society portal and will be operated by the Insurer. The reports will be available for scrutiny on the Mahatma Jyotiba Phule Jeevandayi Aarogya Yojana Society login.

STEP 8: The N Hospital will provide free follow-up consultation, diagnostics, and medicines under the scheme up to 10 days from the date of discharge.

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