What to do if Ayushman card treatment is rejected after approval?

Hello,

If your Ayushman treatment was approved earlier but later rejected, please do not panic. First, ask the hospital to explain the exact reason for the rejection and help you correct the issue.

1. Contact the Ayushman Mitra Desk

Go directly to the hospital's Ayushman Mitra/Ayushman desk or the designated PM-JAY officer.

Ask them for:

• The exact reason for rejection

• Any query raised in the Ayushman system

• Whether any document or medical report is missing

• Whether the treatment package or package code was entered incorrectly

• Whether the case can be corrected and resubmitted

A pre-authorisation request involves supporting medical documents, so missing or incorrect information can affect processing.

2. Submit the Correct Documents

If the rejection is because of a missing report, incorrect information or a package-related issue, ask the hospital's Ayushman team to correct the details and resubmit the request, wherever the scheme process permits.

Keep these documents ready:

• Ayushman Card/e-card

• Aadhaar or valid ID

• Doctor's prescription

• Diagnosis reports

• Blood test reports

• X-ray, CT, MRI or other relevant reports

• Previous treatment records

• Discharge summary, if applicable

• Any document requested by the Ayushman desk

3. Raise an Official Complaint

If the hospital is not explaining the rejection or is refusing to help, you can raise a grievance through the official PM-JAY grievance system.

You can:

• Call the PM-JAY helpline: 14555

4. If It Is an Emergency

If the patient's treatment cannot be delayed, please seek medical care immediately. Emergency cases have a specific PM-JAY process through which the hospital can obtain telephonic approval and generate a Telephonic ID before completing the system formalities.

Please keep copies of all reports, approval/rejection messages, bills and hospital communications. These details will be useful if you need to raise a grievance.

Most importantly, do not delay urgent medical treatment while trying to resolve the paperwork.

Wishing you and your family good health always.
Warm regards,
Team HexaHealth