NEURO SURGERY IS AVAILABLE IN AYUSHMAN? HOW MAY HOSPITALS ALLOW IN VADODARA

Yes, Yogesh ji, appendix surgery (appendectomy) is covered under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) scheme. Eligible beneficiaries can avail of this treatment cashless at any empanelled hospital across India.

Steps to Avail Appendix Surgery Under Ayushman Bharat

1. Verify Eligibility:

   • Ensure you're a registered beneficiary under the Ayushman Bharat scheme.

   • Check eligibility on the PM-JAY Beneficiary Portal.

2. Locate an Empanelled Hospital:

   • Use the PM-JAY Hospital Finder to find empanelled hospitals in Valsad or nearby areas.

3. Prepare Necessary Documents:

   • Ayushman Bharat card or PM-JAY family ID

   • Aadhaar card

   • Medical reports and doctor's referral

4. Visit the Hospital:

   • Approach the Ayushman Bharat helpdesk at the hospital.

   • Present the necessary documents and discuss your condition.

5. Undergo Pre-Authorization Process:

   • The hospital will initiate the pre-authorization request under the Ayushman Bharat scheme.

   • Upon approval, the treatment will proceed without any out-of-pocket expenses.

Namaste Narender ji,

Aapke gallbladder mein 20mm ke 2 stone hain aur aapko operation karwana hai — yeh surgery Ayushman Bharat (PMJAY) card ke through cashless ho sakti hai, agar aapka card valid hai aur hospital empanelled hai.

Gallbladder Surgery Ayushman Card Par Ho Sakti Hai

• Gallbladder stone removal (cholecystectomy) Ayushman Bharat mein covered hai.

• Aapko General Surgery ya Gastroenterology ke under treatment milega.

• West Delhi mein kai private aur government hospitals empanelled hote hain.

West Delhi Mein Treatment Ke Liye Kya Karein?

1. Visit karein:
   https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm?actionFlag=ViewRegisteredHosptlsNew

2. Select karein:

   • State: NCT of Delhi

   • District: West

   • Speciality: General Surgery

   • Captcha daal kar “Search” karein

3. Aapko sabhi Ayushman Bharat empanelled hospitals ki list mil jaayegi jahan aap consult ya admit ho sakte hain.

Zaroori Documents:

• Ayushman Bharat (PMJAY) card ya ABHA ID

• Aadhaar card

• Doctor ki report (Ultrasound, CT, etc.)

• KYC documents (agar hospital maange)

Agar aapko kisi specific hospital ke selection ya process mein madad chahiye ho, to HexaHealth aapki sahayata kar sakta hai.
Aapki surgery safal ho — yahi humari shubhkaamna hai!

Hello Swapnil ji,

Thank you for your question. I understand your concern regarding the hospital bill after your father's surgery. Here's what you need to know:

Can You Claim the Hospital Bill After Surgery?

Before proceeding, it's important to clarify:

Are you referring to the Ayushman Bharat (PM-JAY) scheme or a private health insurance policy?

If It’s Ayushman Bharat Scheme (PM-JAY)

Ayushman Bharat works on a pre-authorization, cashless treatment model. That means:

• The hospital must be empanelled under the scheme

• Approval is required before treatment

• Reimbursement is NOT allowed if you've already paid the bill and Ayushman benefits weren’t used at the time of treatment

What You Can Do:

1. Check if the hospital is empanelled
   Use the official portal:
   👉 https://hospitals.pmjay.gov.in/Search/empnlWorkFlow.htm

2. Speak to the hospital’s Ayushman Coordinator
   Some hospitals may help if eligibility was missed by mistake.

3. File a grievance (if applicable)
   If you believe Ayushman card was valid and the hospital denied it wrongly:

   • 📞 Call: 14555

   • 📝 Submit at: https://cgrms.pmjay.gov.in

If It’s a Private Health Insurance Policy

If your father has a private insurance policy, then reimbursement may be possible, depending on the insurer’s rules.

Steps to Claim:

1. Collect Original Documents:

   • Discharge summary

   • Hospital bill

   • Payment receipts

   • Investigation reports

   • Doctor’s prescription and treatment summary

   • Insurance policy copy

2. File Reimbursement Claim:

   • Submit all documents to your insurer within the allowed timeframe (usually 7–30 days post-discharge)

   • Some insurers allow online submission via their website or mobile app

   • Track claim status using the claim reference number

3. TAT for Reimbursement:

   • Most insurers process claims within 15–30 working days

Wishing your father a full and speedy recovery.