SWASTHYA SATHI

Main Features of the Scheme:

•       Basic health cover for secondary and tertiary care up to Rs. 5 lakh per annum  per family.

•       Up to Rs 1.5 Lakh through Insurance Mode and beyond 1.5 lakh to 5 Lakh through Assurance Mode

Paperless, Cashless, Smart Card based.

•       There is no cap on the family size and Parents from both the Spouse are included. All dependent physically challenged persons in the family are also covered.

•       All pre-existing diseases are covered.

•      The entire premium is borne by the State Government and no contribution from the beneficiary.

•      Online Swathyasathi Smart card is provided to each family on the day of Enrolment. Smart Card captures the details of the family members , Photographs, biometric, address, Mobile Number, SECC ID.

•       Management of the scheme is in paperless IT platform from day one.

•       Online empanelment & gradation of Hospitals based on the services and infrastructure available

•       100% online Pre-authorisation with turnaround time of 24 Hrs.

•       SMS triggers and instant alerts to the beneficiaries on blocking of card.

•       Real-time uploading of E-health record of the beneficiaries on discharge

•       Claim reimbursement to the hospital with TAT of 30 days else interest are being charged for delayed payment.

•       24X7 toll free Call Centre (18003455384)  with feedback option

•       Online grievance monitoring Mechanism

•       Online triggers and alerts to detect probable frauds with escalation matrix.

•       Android based Swasthya Sathi Mobile app for assistance to the beneficiaries.

      Services Provided at Swasthya Sathi Kiosk

  • Enrollment of beneficiaries.
  • Addition of dependents’ names on the beneficiaries’ cards.
  • Re-print of cards (in case of lost OR damaged OR chip error).

        Services Provided at Swasthya Sathi Cell

  • Arrangement of providing Swasthya Sathi cards to the beneficiaries on urgent basis.
  • Correction of name, age, aadhar number etc in the server against Swasthya Sathi URN.
  • Searching of names of eligible beneficiaries using UID, Ration Card No, Phone number.

Arrangement of providing the duplicate re-printed cards(in case of lost OR damaged OR Chip error).

Biswa Bangla