Rajiv Aarogyasri Community Health Insurance Scheme
Description
Rajiv Aarogyasri Health Insurance Scheme is a state of the art health initiate of Government of Andhra Pradesh with a mission to improve access of below poverty line (BPL) families to quality medical care for treatment of identified diseases involving hospitalization, surgeries and therapies. The primary channel through which Aarogyasri Scheme is utilized by the target groups is through its ICT Website. The Website Portal is a workflow oriented integrated system which takes care of the target groups right from the registrations of a patient to the discharge, claim settlement and then administering of follow up medicine to the patients. Each phase through which a patient goes through, be it In-patient registration/Out-Patient registration/Surgery Updates/Discharge Updates/Claim Settlements etc., everything is taken care by the ICT itself. Every user who facilitates the patient is provided with a Login Id and Password using which he/she would login to the system and operate on the details pertinent to patient. The Users who facilitate the patients would have to use the ICT and provide their appropriate inputs and use the responses obtained from the ICT to help the patient get a successful treatment and happy discharge.
What we deliver?
ICT solution is rendered to the customer. The primary channel through which Aarogyasri Scheme is utilized by the target groups is through its ICT Website. The Website Portal is a workflow oriented integrated system which takes care of the target groups right from the registrations of a patient to the discharge, claim settlement and then administering of follow up medicine to the patients. Each phase through which a patient goes through, be it In-patient registration/Out-Patient registration/Surgery Updates/Discharge Updates/Claim Settlements etc., everything is taken care by the ICT itself. Every user who facilitates the patient is provided with a Login Id and Password using which he/she would login to the system and operate on the details pertinent to patient. The Users who facilitate the patients would have to use the ICT and provide their appropriate inputs and use the responses obtained from the ICT to help the patient get a successful treatment and happy discharge. ICT provides for the following: General Information on the scheme. Details of patients reporting and referrals from the PHC/CHC/Government Hospitals/ District hospitals on daily basis e-Health Camps system and daily reporting of health camps Details of patients reporting and getting referred from the health camps. e-Empanelment system Emergency approval system Call centre application. Patient registration by Aarogyamithra in Network Hospitals Details of in-patients and out patients in the network hospitals On-bed reporting system Costing of the Tests done in the network hospitals e-preauthorization Surgery details Discharge details Real-time reporting, active data warehousing and analysis system Claim settlement Electronic clearance of bills with payment gateway Follow-up of patient after surgery Distribution of Follow-up medicines Aarogyasri Messaging Services Enhancement workflow Grievance and Feedback workflow Bug Tracking system e-Office management Accounting system TDS workflow Death reporting system.
Whom we deliver
Department of Government Patients (Men, women and children) Government Hospitals Private Hospitals Donors Public in general to know more about the scheme.
Why is the project unique?
Scheme provides universal coverage to BPL families in the state irrespective of age, sex, social status and family size for all pre-existing diseases in the identified 942 procedures. The sole criterion to be covered under the scheme is to hold BPL ration card with photo and name. The entire premium required to be paid for a family is borne by the government. The packages designed by experts group covers the entire treatment process of the beneficiaries starting right from the reporting to the hospital till his discharge and 10 days medication after discharge making the services truly cashless to the beneficiary. All the network hospitals have to conduct at least one free health camp in identified rural areas to screen the BPL population. Further the hospitals will conduct IEC activity and provide basic treatment facilities for the common ailments for other patients. Aarogyamithras (Health Facilitator) are stationed at each point of contact of the patients. CUG (Closed User Group) connectivity among Aarogyamithras, RAAMCOs, AAMCOs, Field Officials and officials at Head Office provided for easy and round the clock connectivity. IT based online processing starting from registration of patient from health camp, referral, registration at the network hospital, pre-authorization, patient clinical details including diagnostic tests, claim monitoring, processing and payment. 24×7 Call center with Toll free Number Disciplinary actions against erring hospitals through a dedicated committee with laid down guidelines Grievance Redress Mechanism through dedicated staff Online accounting system for Trust office for better financial discipline Online TDS payment application.
Roadmap
Connecting Primary Health Care Centers availing Mobile technologies To provide a call centre based health help line services to the populace which provides basic medicare services including directory services To develop blood and organ donation modules and a comprehensive way to integrate all such donation centres across AP Comprehensive Service Intelligence tool implementation (Business intelligence) along with the analytics and real time alerts and future trends etc IRIS integration for more security and authentication of the beneficiary Expanding the coverage of number of various surgeries/procedures to make universal coverage Making a comprehensive accounts module in the solution Making every critical step in the process flow a SLA based Making the ICT solution most economical by adopting to complete open source technologies while maintaining the robustness and reliability Making the solution scalable to accommodate all the users from all hospitals across AP.
Contact
Rajiv Aarogyasri Health Care Trust
Sri N. Srikanth, IAS
Aarogyasri Health Care Trust, Dr. Y. S. R. Bhavan, Opp: Dr. B. R. Ambedkar Open University, Road No. 46, Jubilee Hills Hyderabad Andhra Pradesh, India 500033
110014
URL/Website – www.aarogyasri.org
