Eden Medical Centre in Dimapur has announced the suspension of services under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) for the Rs 5 lakh category, effective 22 May 2024. The hospital cited delays in claim processing and compensation from the insurance company as the primary reason for this decision.
In a notification, Eden Medical Centre expressed hope that the Government and Health Department would resolve the issue promptly, allowing the resumption of services.
NHAP ensures resumption of claims processing for PM-JAY and CMHIS
Meanwhile, Thavaseelan K., IAS, CEO of the Nagaland Health Protection Society (NHPS) issued a press statement on Tuesday addressing the situation. He informed all empaneled hospitals and beneficiaries of PM-JAY and the Chief Minister Health Insurance Scheme (CMHIS) that the National Health Authority (NHA) has recently migrated to a new IT portal for claims processing and the state has also onboarded a new insurance company as the insurer for the scheme.
“With the migration and onboarding of the new insurer, there have been some IT issues in processing claims and making claim payments to the hospitals. We are pleased to inform you that the issues have been resolved and claims payment processing has been re-initiated,” said Thavaseelan.
The PAB-PMJAY and the Chief Minister Health Insurance Scheme (CMHIS) are implemented using the IT platform provided by the National Health Authority (NHA).
Thavaseelan requested all empaneled hospitals to continue providing services under PM-JAY and CMHIS without disruption, assuring that claims payments are now being processed.