Cardiology surgeries in KEM under RGJAY take hit

RGJAY was launched in 2012 by the state government to provide free healthcare services to around two crore below-poverty-line and above-poverty-line patients in the state. The scheme has, however, faced problems in public hospitals where a huge inflow of patients has led to difficulty in documentation and claim of payment from the Kolkata-headquartered National Insurance Corporation (NIC).

Ram Avtar Gupta, father of three-year-old Kishan Gupta who requires a balloon pulmonary valvotomy, said, “We have been waiting for his surgery since the last eight months under the RGJAY scheme. KEM hospital administration has consistently told me that the material for surgery has not arrived.” Bhayander based Gupta is now looking for other options for his son in absence of enough finance to get Kishan operated without the scheme.

Dr Prafulla Kerkar, Head, Cardiology department at the hospital, admitted that a problem with vendors not supplying under the scheme is currently responsible for the delay in surgeries. “We do not want the patients to suffer. But what can we do if the vendors are not willing to supply,” he said. Deputy Dean Dr Milind Salve, who oversees the RGJAY management in the hospital, however said, “When the problem with RGJAY arose two months ago, we sorted out everything. Now the process is very smooth. We are uploading all the documents on time for re-payment from the insurance companies.”

Dr Shubhangi Parkar, dean in-charge at KEM, said, “Only the bills of vendors need to be signed and the payment will be done. We have called all the vendors to discuss the problem and the outstanding amount is not high. We are working to solve it quickly.”

Sources said doctors performing surgeries are supposed to overlook the process of filing documents for claims from the government. The huge work-load has led to clerical errors due to which several claims are rejected.