Jan Aadhar Enrollment Registration on SSO Portal For Pensioners - Workflow For Pensioners - Guidelines Jan Aadhaar Enrollment using RGHS Reimbursement Guideline-Beneficiary For AIS-Serving For Serving Employees Edit Functionality Guidelines OPD Fund Enhancement Guideline for Beneficiaries

User Guidelines for TMS Extended Stay, TID Conversion and Medicine Line Item TMS TID Conversion User Guideline Booking Package Code for 350 Consultation Fee Guidelines for Empanelment of pharma stores HCNP Diagnostic Imaging Center User Guide Pre-auth Guideline Day Care Guideline EOI for Empanelment of Hospitals - 1st may 2023 EOI for Empanelment of Hospitals - 7th dec 2022 Transaction Management System (TMS)(NEW) TMS guidelines for Government hospitals EOI for New Empanelment of Hospitals

Guidelines for uploading un-uploaded prescriptions from the pharmacy level EOI for Empanelment of pharma stores and e-pharma EOI for Empanelment of Ayush Pharmacy

Cashless Hospitalization: The beneficiaries of RGHS can avail cashless hospitalization in all Government and duly empanelled private hospitals of the State. The complete list is available on RGHS web-portal: www.rghs.rajasthan.gov inand as the name suggests, a cashless treatment means that the beneficiary does not have to bear the cost of a medical treatment. The costs will be borne by the government. Cashless facility shall be offered only at empanelled Health care Network providers (HCNP) including all Government and Private hospitals, Diagnostic / Imaging centers under RGHS at the prescribed CGHS rates.

Cashless OPD Medicines: The beneficiaries of RGHS can avail OPD cashless medicines from Government owned CONFED stores as well as from Private empanelled Pharma Stores. The complete list is available on RGHS web-portal:www.rghs.rajasthan.gov.in. RGHS beneficiary will also be able to upload the OPD prescription with the given facility on their registered SSO login ID along with a “VIEW PHARMACY” option to see the list of Pharma stores as per the District and City location.

A large number of Empanelled Hospitals and Pharma stores: To provide maximum benefits to all the beneficiaries a large number of private hospitals and Pharma stores are empanelled under the scheme across the State. This will help to cater the patients at the time of medical emergency.

Empanelment of Diagnostic Centre/ Imaging centre: All RGHS Beneficiaries can also avail the services of especially diagnostic centres/ Imaging centres for investigations and tests for easy and hassle free diagnosis of the disease as an added feature in medical facilities along with novel e – pharma facility. This will bring all the health coverage facilities under one umbrella for imparting holistic treatment facilties. City location.

Wide Coverage of Medical facilities: RGHS offers a comprehensive package of treatment offering coverage that pays for the entire cycle of medical emergency as well as for OPD/IPD/Day Care, maternity and Child care facility. All the packages and rates will be as per the CGHS guidelines and therefore Beneficiary does not have to pay the hospital private designed rates.

RGHS Card Tracker System: All RGHS beneficiary have an accessibility of RGHS card Tracker facility on their registered SSO login ID which will have a feature of OPD and IPD card limit display as per their applicable category.

facility for Pensioner’s: RGHS beneficiary falling under the Pensioner category (under RCS (Pension) Rules 1996) can also avail the facility of online OPD enhancement, an easy and hassle free system developed to provide maximum benefit so that they can have a real time provision of the availability of the funds for the required medicines.

Facility For SAB (serving and Retired employees): For RGHS beneficiaries, especially SAB serving and Retired employees a sum insurance of Rs 5 lakhs (Rs. 20,000 OPD inclusive) will be admissible per family per year with an extra sum of Rs 5 lakhs coverage per family per year for any catastrophic illness as specified within the scheme.

Automated IT enabled facility: Enhancing e-governance in the State, RGHS includes a completely automated IT enabling facility for Seamless Registration, Healthcare Network Provider (HCNP) empanelment, Beneficiary Identification Selection (BIS), RGHS Package selection for treatment, Transaction Management and Claim settlement and Grievance redressal mechanism making it a complete paperless system. This will have minimum documentation at each level and will provide a hassle free admission, treatment and discharge to the RGHS beneficiary for any medical treatment at a hospital.

Online processing of HCNP Empanelment: The entire Private Health care network Providers (HCNP) can use the online empanelment module for applying for empanelment under RGHS through the RGHS web portal. The selection process for approval/rejection of the HCNP application by the Health benefit Empowered Committee(HBEC) will also work on online and automated module in a time bound manner. The Empanelment of private Pharma Store is also an online empanelment module.

Besides private hospital empanelment in the State of Rajasthan, few selected multi-specialty / Specialty private hospitals are also registered under the scheme outside the State enabling the beneficiaries to opt for the medical facilities in case of dire need whenever required outside Rajasthan.

RGHS beneficiary will have its own electronic medical record for easy access to the medical history and to avail the best medical facilities in selected State Government and empanelled private Hospitals.

Self Printing of RGHS e-card: Since RGHS is an automated IT enabled module, beneficiaries can print their own RGHS e-card on RGHS web-portal: www.rghs.rajasthan.gov.in to avail the medical facility.

Add-on/Deletion of dependent family members as beneficiary:All RGHS beneficiaries will have an access to any change in add-on/ deletion feature of dependent Family members using SSO login Id and Edit module on RGHS web-portal.

Single RGHS Card Number All the Eligible dependent Family members of RGHS card holder will have a single unique ID number printed on the RGHS card.

There are certain hospital / medical treatments and non payable items which are not included within the scheme and are not covered in the claims. These conditions and features are as per enlisted in CGHS guidelines.