The Chief Minister of West Bengal State, Mamta Banerjee, announced the Swasthya Sathi Health Scheme 2022, which will cover everyone in West Bengal. The Chief Minister of West Bengal State has implemented a slew of new policies to assist residents in improving their financial situations and avoiding the severe consequences of the coronavirus. According to the Chief Minister’s statement, the new strategy was put into action on December 1, 2020. She went on to say that the Cashless Health Scheme was made possible through funding from the West Bengal State Government.
The Swasthya Sathi Act, 2016 was passed in the Cabinet on February 17, 2016. On February 25, 2016, the Department of Finance issued a notice stating that all modifications were completed and recommended approval of this matter. The West Bengal government formally launched the plan on December 30, 2016.
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Swasthya Sathi Scheme Details
- Secondary and tertiary hospitalization are covered by basic health insurance for each household for up to Rs. 5 lakh per year.
- All of these methods are completely digital.
- The policy covers every pre-existing condition.
- There is no limit to the number of dependent children in a family, and both spouses’ parents are included
- All physically disabled persons in the family are covered.
- The insured pays nothing toward the premium. The state covers the entire cost.
- Swathya Sathi Smart Card is given to all families at the time of enrollment.
- The smart card holds all of the household members’ information, photographs, biometrics, address, mobile number, and SECC ID.
- Since the inception of the project, a paperless IT platform has been used to manage it.
- Hospitals are rated and enrolled on the online platform based on their services and infrastructure. Preauthorizations are completed entirely online and take 24 hours to complete.
- Beneficiaries will be informed by SMS or emergency notifications if their cards are blocked.
- On discharge, real-time information uploading of beneficiaries’ E-health records to the database.
- Reimbursement to the hospital will be allowed after 30 days, with interest charged for late payment if the TAT is exceeded.
- The phone number can be reached by calling the 24X7 toll-free Call Center (18003455384) with the feedback option.
- System for monitoring customer complaints
- Auto-generated email alerts and logins from recent transactions to identify fraudulent activity. An escalation matrix is provided to handle problems.
- The Swasthya Sathi mobile app is available for beneficiaries to use.
- The Swasthya Sathi Form may be downloaded from the official website.
2022 Swasthya Sathi Scheme (Smart Card)
Apply Online for the WB Swasthya Sathi Smart Card | West Bengal Swasthya Sathi Smart Card Apply Online | West Bengal New Cashless Healthcare Scheme Registration & Eligibility. Today, we’ll go through the new Swasthya Sathi scheme in detail so that you can enroll and get the advantages of excellent healthcare affordably or for free. We’ll go over the application and age requirements for enrolling in West Bengal’s Swasthya Sathi Smart Card project, which was announced by the state’s Chief Minister. We’ll also walk you through the application process for Swasthya Sathi 2022 and how to get this smart card.
Benefits of Swasthya Sathi Cashless Health Scheme 2022
According to forecasts, at least 7.5 crore people will take part in West Bengal’s Cashless Health Scheme. The state’s Chief Minister announced that the Swasthya Sathi scheme will benefit all families in West Bengal. The state’s chief minister added that the Centre pays only 60% of the cost of the Ayushman Bharat Yojana, but the state government will cover all costs for Swasthya Sathi Cashless Healthcare Scheme.
The smart card will provide the main advantage of this technique. Every family in West Bengal will receive a smart card, which will be accepted at all government and private hospitals.
Name of the Scheme is Swasthya Sathi Scheme, Smart Health Card, which was created by Mamata Banerjee, the Chief Minister of West Bengal. The objective of this project is to provide basic health services at an affordable price. People in West Bengal are its beneficiaries. Official website: https://swasthyasathi.gov.
Letter of Appreciation for the Swasthya Sathi Scheme
As you are all aware, the West Bengal Duar Campaign is being implemented throughout the state. Individuals are enrolling in a variety of government programs as a result of this campaign. All Swasthya Sathi recipients who joined through the Duare Sarkar campaign and were verified would receive an official letter from the West Bengal government on January 8, 2022, according to West Bengal government plans. This letter will be written by Chief Minister Mamata Banerjee. This letter is to convey my gratitude for the Swasthya Sathi plan’s beneficiaries receiving a message. In this note, the Premier addressed the recipients as “Dear Companions.” She informed us about the Duare campaign, which will begin on December 1st next year.
In this letter, she stated that with the aid of this effort, the West Bengal government would provide the people of West Bengal with access to 12 programs. Approximately 1,88,99,552 people visited the 665 Duare Sarkar camps between January 7 and January 7, 2022.
Stats about Swasthya Sathi Scheme
Families that are Covered under the Swasthya Sathi Scheme, 2 Crores Plus Hospital Enlisted Under Plan 2260 Plus Hospitalization Have Been Accomplished Till Date 20 Lakhs Plus Families Covered under the Swasthya Sathi Scheme.
Concerns have been raised about the West Bengal Swasthya Sathi Scheme
The state of West Bengal gives Swasthya Sathi, a health insurance program that covers up to Rs 5 lakh in expenses. On December 27, 2020, officials from the public and private sectors met to discuss healthcare issues. Representatives from private hospitals met to discuss treatment costs under the swasthya sathi program.
The program is referred to as the “Swasthya Sathi” in these places. The rates are said to be exceptionally low, according to Dr. Barua. The significance of health insurance coverage has been challenged by both the government and private healthcare providers.
- some reservations are expressed by private hospitals
- The first challenge was the cost of care under the Swasthya Sathi program.
- Hospitals that are not part of the government’s healthcare network have requested that the fees under this plan be altered. During the meeting, treatment expenses and the type of therapy were also considered.
- Private hospitals addressed the government that no payments be deferred for months.
- During this meeting, it was decided to upgrade infrastructure and equipment
- Surgery Rates : Common Surgery Rs 19,500 , Replacement Surgery Rs 85,000 and Open Heart Surgery Rs 80,000.
The Swasthya Sathi Smart Card is a smart card developed by Swasthya Sathi
Swasthya Sathi Smart Cards will be distributed to households with at least one elderly woman as part of this program. People will be able to use the Smart Card at any commercial or public government hospital that accepts it for healthcare services. Because the program has been expanded to apply to all West Bengal residents, no special qualifications are necessary. The state spends about Rs. 2,000 crore each year on this Health Scheme. Individuals will be able to receive various therapies without having to pay any money to the hospital administration if they use smart cards.
The Requirements for the Swasthya Sathi Program
To enroll in the Cashless Health Scheme, you must fulfill the following criteria.
•The applicant must be a permanent resident of West Bengal.
•The smart card will be given out to the family’s female prospects.
• An applicant must not be enrolled in another government healthcare program.
The Important Facts of the Swasthya Sathi Scheme
- The Swasthya Sathi Scheme 2022 will provide secondary and tertiary care for Rs 5 lakh per household per year, according to the basic health coverage levels.
- All pre-existing conditions are covered by the policy.
- There are no limits to the size of your family.
- The Swasthya Sathi Scheme protects the family’s parents, as well as any physically challenged people in the household.
- Under the Swasthya Sathi program, the West Bengal government will cover the full premium cost.
- The beneficiaries are not charged a fee.
- An online swasthya Sathi smart card will be provided to each participating household that includes data about family members, a photograph, biometrics, an address, a phone number, and so on.
- The swasthya Sathi program offers phone assistance 24 hours a day, seven days a week.
Swastha Sathi’s Major Purpose:
There are no exclusions: The plan covers any prior illnesses or conditions from the start.
- There is no family size limitation, and parents of both spouses are included. There is also gender equality: there is no family size limit, and males and females are covered equally. The name of the eldest female family member as Head of household is usually on cards.
- Because West Bengal’s government covers the whole premium, including smart cards, the beneficiary is not required to pay any insurance premiums or card fees.
- Transactions based on the 64Kb Smart Card: The beneficiary receives paperless, cashless services that are entirely dependent on the 64Kb Smart Card Embedded with a digitally secure message, it’s imprinted on the card and delivered to just the beneficiary at the time of registration. Smart cards are valid for one year and must be renewed each year.
- The entire infrastructure of the plan is paperless and built on a user-friendly cloud-based IT architecture. Online monitoring of the project, in addition to ensuring that services are provided as soon as possible, saves time and resources.
- Treatment Pre-Authorization: Within 24 hours after receiving a medical request from Swasthya Sathi, all beneficiaries’ healthcare procedures/treatments are pre-authorized.
- Hospitals are rated on their accessible features and services, which are physically verified by the IC/TPA (Insurance Company/Third Party Administrator). It is then assessed and confirmed by an Empanelment Committee.
- The beneficiary is not entitled to reimbursement for expenses for consulting, diagnostic tests, and medicines up to one day before the patient’s admission, as well as the cost of diagnostic tests other than food throughout hospitalization. Expenses for consultation, diagnostic tests, and medicines up to five days after discharge from the hospital for the same ailment or surgery are reimbursed.
- Comparison of Package Rates: The program offers 2092 Swasthya Sathi packages. Package prices are determined on a case-by-case basis by the Package Selection Committee and rationalized.
- Beneficiaries receive text message alerts both before and after their stay, as well as during their release.
- Swasthya Sathi Mobile App: The Google Play Store has this app, which lets you submit a request for information, file a complaint, and so on.
- The Help Line is accessible 24 hours a day, 7 days a week via this phone. It also has a one-touch operation that connects you to the Helpline.
- The bottom of the Swasthya Sathi Smart Card includes a 24-hour toll-free help call centre (Number-18003455384), as well as access to an online website with information on how to use the card.
- Beneficiaries can also communicate with one another through social media sites such as Facebook, Twitter, and WhatsApp.
- After discharge, the patient is reimbursed Rs 200 in transportation costs.
- Furthermore, patients who are admitted to state-run hospitals receive a travel allowance of Rs 200 in addition to the Rs 200 they would have received otherwise.
- Under the Swasthya Sathi program, beneficiaries can access a network of empanelled hospitals that includes over 1500 facilities. On a daily basis, a growing number of hospitals self-register for the plan, which is public information.
- The claim must be submitted within 30 days after the initial contact, or else the insurance company may charge interest on the contract.
- The portal requires each patient’s e-Health records to be uploaded, which means that physicians may access them as needed using their login credentials. As a consequence, all stakeholders, including the general public, have access to the report.
- Stakeholders can use the Swasthya Sathi online site to submit a complaint.
- There are System-Based Triggers to Fight Hospital/TPA/Insurance, such as hospitals with high admissions, a high number of pricey packages blocked, a premium package banned and claimed but not really done, needless surgery to be conducted or maintained in the ICU, the same packages being blocked for many individuals at particular times, and so
- 34,43,436 people had visited the website as of November 30th, 2019. For routine viewer inquiries, there is an interactive “May I Help You” option. Using a simple web browser application, the webportal also allows individuals who are not enrolled to verify their eligibility and enrollment information.
Hospitals Associated with the West Bengal Health Scheme
Uniting of West Bengal Health Scheme hospitals, clinics, labs and diagnostic units
- This category includes public health clinics, as well as other local government services such as fire rescue and community planning.
- The Ramkrishna Mission Seva Pratisthan (Ramkrishna Mission Seva Pratisthan), Sarat Bose Road, Kolkata is a nonprofit organization dedicated to relieving human suffering through the message of Sri Ramakrishna.
- Marwari Relief Society Hospital , Islamia Hospital Kolkata
- The Institute of Child Health Kolkata
- Balananda Brahmachari Hospital Kolkata
- Chittaranjan Cancer Hospital Kolkata
- Ramkrishna Sarada Mission Matri Bhavan Kolkata
- Dr. M. N. Chatterjee Memorial Eye Hospital
- Ramkrishna Matri Mangal Pratisthan ,B.C. Roy Sishu Sadan North 24 Parganas
- J.N. Roy Sishu Seva Bhavan
- Chartoris Hospital, Darjeeling
- Kalimpong Leprosy Hospital Darjeeling.
- Sri Balaram Seva Mandir , North 24 Parganas
Services Provided by Swasthya Sathi
- Empanelment of a Hospital
- Furthermore, the hospital’s rating (which will be based on infrastructure and services).
- A transaction is said to be non-cash if it does not involve any cash, notes, or coins.
- Quality assurance of nursing documentation is critical.
- If you don’t pay your bills on time, you will be charged interest.
- Complaints on Web Sites.
- There is also call assistance available at any hour of the day or night, seven days a week.
- You can use email marketing software to deliver messages in real time.
- Card Notifications via SMS
- The process of creating a new account takes about 30 days, including the signing up and verification processes.
- A Swasthya Sathi Android app is available. It can be downloaded from the Google Play Store.
The Swasthya Sathi Notices are available for viewing:
- Visit the official website of the Swasthya Sathi program.
- In front of you the home page will appear.
- Select the notice option from the webpage
- In front of you a new page will appear
- In front of you a list of notices will be shown
- Because you’re logged in, you’ll see a new page with all of your notifications on it. You must now select one of the notifications from this list..
- A window will appear on your computer screen, displaying all of the required information.
Orders of the Government can be downloaded by following process :
- Visit the Swasthya Sathi website
- You should see the homepage before you get started.
- You’re now on the government order page.
- Displayed in front of you are all government orders
- Select an order by clicking
- In front of you a pdf file will appear
- Get it downloaded from there
Tenders can be downloaded.
- Open Swasthya Sathi scheme website.
- In front of you, the homepage will appear
- Select tenders option on the homepage
- In front of you, a list of tenders will be shown
- Choose and select the tender you want
- In front of you a pdf file will appear
- Download it from there
- Tender would be saved
Administration and Team Formation
- For more information, go to the Swasthya Sathi Scheme’s official website.
- In front of you, the homepage will appear
- Click on the About Swasthya Sathi link
- Select Administration and team setup.
- In front of you a new page will appear
- You can examine Administration and team setup on the page
The Organization’s Structure
- Open Swasthya Sathi website.
- In front of you the home page will appear
- Select the Swasthya Sathi
- Select institutional structure.
- In front of you a new page will appear
- You may see the organizational structure in this page
Swasthya Sathi Contact Number
The contact for the helpline is 18003455384.
Frequently Asked Questions (FAQs)
If the Swasthya Sathi Card isn’t paid in full within 24 hours of being admitted to a hospital, the Beneficiary will be responsible for any expenses. You may contact us between 9 a.m. and 9 p.m. Monday through Saturday at 1800 345 5384 (Toll-Free).
Information such as the date of discharge and SMS notification on the registered phone are two examples of information that may be obtained from these sources. Search for your URN number using the Mobile App, which you can get from Google Play. You can also contact at 1800 345 5384.
A list of hospitals (both public and private) is provided when you enroll; for further information, see the hospital brochure. Dial the hotline number that came with your smart card. Using the Mobile App, you may search for a network hospital under the ‘active hospital’ tab.
You can also check the website, https://swasthyasathi.gov.in.
Hospitals are empanelled based on the qualifying criteria, both public and private. Based on their facilities and infrastructure, Grade A, B, C, and R hospitals are graded. The recipient has the choice of which hospitals they want to visit. You may use our Mobile App or our Website to locate available healthcare institutions
The plan provides a list of affiliated hospitals to beneficiaries on card issuance. If the beneficiary needs medical care, he or she must visit one of these hospitals or any other additional institutions later added to the list of empanelled facilities. Confirm the information on our Mobile App/Website or call our 24-hour Toll Free Call Center.
You will receive a list of hospitals at the time of the card issue. The toll-free helpline number listed on the back of the Smart Card may provide you with information about other hospitals (1800-345-5384) as well as these and other facilities
Swasthya Sathi is a cashless program, in which treatment expenses of up to Rs 5,00,000 (per family per year) are reimbursed via smart card. THE BENEFICIARY OF THE SWASTHYA SATHI SCHEME DOES NOT HAVE TO UNDERGO TREATMENT.
The phrase “cashless service” implies that the patient will not be charged for treatment or hospitalization.
As a result, treatment packages for Swasthya Sathi already include pharmaceutical expenses
The cost of an OPD consultation is not covered; however, if the OPD is changed to IPD, the Scheme will cover the whole treatment expense.
Hospitals are responsible for making sure that all drugs and tests needed for treatment are available. If the patient followed the Hospital’s recommendations/instructions when obtaining it, he or she can return the cash memo/receipt and get the money back.
The payment for transportation under SWASTHYA SATHI is limited to Rs. 200 per hospitalization and Rs. 2000 per policy year, however, if the treatment is received at a Government Hospital with a Swasthya Sathi card, an additional travel allowance of Rs 400 to Rs 700 is given, and the recipient receives transport money of Rs 400 to Rs 700.
Regardless of the mode of transportation, the maximum payment for hospitalization under SWASTHYA SATHI is Rs. 200 per hospitalization and Rs. 2000 per year for private hospitals
Is there a way to check the smart card’s balance?
Dial the hotline number that came with your smart card. The Google Play Store may be used to download the Mobile App, which can be used to activate and deactivate your account.
Fraud and abuse of the smart card may be prevented by matching a user’s fingerprints.
One can use fingerprints of every family member.
The patient will receive necessary medications, tests, and so on from the hospital. The hospital will reimburse you when you show proof of a purchase bill.
A package fee implies that all treatment-related costs, such as medications, tests, bed charges, other supplies, meals, and so on, are included in the bundle and will not be deducted from the patient’s bank account.
If the insurance company/SNA refuses to pay for an illness that isn’t covered by the package rate, the hospital will request authorization from the insurer / SNA by completing a Pre-Auth form before blocking payments. Depending on the sort of condition, this will happen within 24 hours.
Because of this, the hospital and insurance company/SNA will be responsible for making alternative arrangements in the event that the smart card reader goes down. If the beneficiary’s identity is confirmed, no treatment will be denied.
The patient will be assisted by SWASHTYA SATHI, who will be stationed at a hospital counter.
The patient simply has to bring their smart card and any other government-issued identification wallet with them when going to the hospital. Also, please include your current phone number so that we may better serve you.
To access the service, you must have a smart card. In extreme circumstances, hospitals may authorize it after proper verification, which SHOULD BE WITHIN 24 HOURS. Please notify the hospital that the Smart Card will be ready in 24 hours.
If you are admitted to the hospital as a result of your condition or treatment, Medicare will pay for it. You receive consultations with the OPD at no cost.
If no hospitalization is required, the patient must pay for it.
The patient should notify the DKM / SNA immediately by calling the toll-free number provided in the handout upon enrollment. The Mobile App may also be used to submit a complaint.