F. No. S.11024/8/2011/CGHS(P)
Government of India
Ministry of Health and Family Welfare
Department of Health and Family Welfare
Directorate General of C,G.H.S.
Nirman Bhawan, New Delhi
Dated the 14th November, 2011
CIRCULAR
SUBJECT : Streamlining of Procedure for disposal of Medical Reimbursement Claims (MRCs) in CGHS
The pensioner CGHS beneficiaries and their dependent family members are entitled to get cashless medical treatment In CGHS empanelled private hospitals on a referral by a Government medical specialist / CMO in-charge, after obtaining prior permission from the CMO in-charge of the CGHS Wellness Centre/Dispensary they are attached to. They are however, also entitled to obtain the medical services from any un-empanelled hospital in emergency condition and get reimbursement of medical expenses incurred by themselves or any of their dependent family members. They can file Medical Reimbursement Claims (MRCs) with the respective CGHS Wellness Centres they are attached to- The CMO In charge is expected to scrutinize the claim papers with reference to the prescribed Checklist and forward the same to the Office of AD/ JD in charge of the zone/city. The Office of AD/JD processes the claim and arranges reimbursement of the admissible amount to the pensioner beneficiary at the earliest.
