PM-JAY, CGHS, ECHS, ESIC and state schemes — package rates, documentation and the deductions that follow.
Ayushman Bharat pays a defined package. Understanding what sits inside it decides whether the case is viable.
Government schemesBeneficiary verification, pre-authorisation and discharge documentation under the scheme.
Government schemesAccreditation changes your rate. Whether it changes your economics is a separate calculation.
Government schemesThe ex-servicemen scheme has its own referral chain, and claims fail on it more than on clinical grounds.
Government schemesHow ESIC referrals reach an empanelled hospital, and what the reimbursement path looks like.
Government schemesAarogyasri, MJPJAY, Chief Minister's schemes — package rates and processes differ by state.
Government schemesScheme volume is predictable and thin-margin. Getting the ratio wrong is a capacity decision, not a billing one.
Government schemesA revision changes which cases are viable overnight, and rate cards need to move with it.
Government schemesA different process from private payers, with different timelines.
Government schemesIdentity failures are the largest single cause of scheme claim loss.
Government schemesA viability calculation, not a billing one.
Government schemesWhat the process requires and what it changes about your operations.