Organizations

Dr.NTR Vaidya Seva

Background

Consequent on re-organisation of the United State of Andhra Pradesh into two states viz: Telangana and Andhra Pradesh. The Government of Andhra Pradesh had renamed the existing "Rajiv Aarogyasri Scheme" as "Dr.NTR Vaidya Seva" and also enhanced the financial coverage from Rs. 2.00 Lakhs to 2.50 Lakhs per family per annum; adding hundred (100) procedures to the already existing 938 procedures vide G.O.Ms. No.157 HM & FM (I.1) Department Dt: 17.12.2014. Thus a new Trust was registered vide G.O.RT. No.404 HM & FM (I.1) Department Dt:05.08.2015 on 23.09.2015 in the name of Dr.NTR Vaidya Seva Trust for operating Dr.NTR Vaidya Seva Scheme.

We can highlight in this page about Dr.NTR Vaidya Seva" enhanced the financial coverage from Rs. 2.00 Lakhs to 2.50 Lakhs per family per annum and covers over 1038 procedures. Dr.NTR Vaidya Seva scheme is unique in its applicability since no other State/ government agency has provided universal health coverage to the poor

Objectives

Dr.NTR Vaidya Seva is the flagship scheme of all health initiatives of the State Government with a mission to provide quality healthcare to the poor. The aim of the Government is to achieve "Health for All" In order to facilitate the effective implementation of the scheme, the State Government had set up the Dr.NTR Vaidya Seva Trust and the beneficiaries of the scheme are the members of Below Poverty Line (BPL) families as enumerated and photographed in White Ration Card and available in Civil Supplies Department database.

This scheme certainly counts to be one of the pioneers in terms of achieving equity and providing accountable and evidence-based good-quality health-care services in the state to assist poor families from catastrophic health expenditure. The aim of the Government is to provide Universal Health Coverage to BPL families. The scheme is a unique in the field of Health Insurance; tailor made to the health needs of poor patients and provides end-to-end cashless services for identified diseases under secondary and tertiary care through a network of service providers from Government and private sector.

The scheme has established a demand-side mechanism that mobilizes and channels additional public financing to health, introduced an explicit benefits package and pioneered cashless care. The scheme is designed in such a way that the benefit in the primary care is addressed through free screening and outpatient consultation both in the health camps and in the network hospitals as part of scheme implementation. The IEC activity during the health camps, screening, counselling and treatment of common ailments in the health camps and out-patient services in network hospitals are supplementing the government health care system in preventive and primary care.

The Trust, in consultation with the specialists in the field of insurance and healthcare, runs the scheme.Dr.NTR Vaidya Seva scheme is unique in its applicability since no other State/ government agency has provided universal health coverage to the poor. The choice of hospital for treatment is with the patient. The entire process from the time of conduct of health camps to the screening, diagnosing , treatment, follow- up and claim payment is made transparent through online web based processing to prevent any misuse and fraud.

The scheme is complimentary to facilities available in government hospitals and put together provides to BPL population including Prevention, Primary care and In-Patient care. All the Primary Health Ce es (PHCs) which are the first contact point, Area/District Hospitals and Network Hospitals, are provided with Help Desks manned by VAIDYA MITHRA's to facilitate the illiterate patients.

Geometry of health insurance coverage:

Population coverage (Breadth of Universal Health coverage) the beneficiaries of the scheme are the members of Below Poverty Line (BPL) families as enumerated and photographed in White Ration Card linked with Adhar card and available in Civil Supplies Department database.

Financial coverage (Height of Universal Health coverage) the scheme shall provide coverage for the services to the beneficiaries up to Rs.2.50 lakh per family per annum on floater basis. There shall be no co-payment under this scheme.

Benefit Coverage (Depth of Universal Health coverage)

  • Out-Patient: The scheme is designed in such a way that the benefit in the primary care is addressed through free screening and outpatient consultation both in the health camps and in the network hospitals as part of scheme implementation
  • In-patient: The scheme shall provide coverage for the 1044 "Listed Therapies" for identified diseases in the 29 categories
  • Package includes the following services: End-to-end cashless service offered through a NWH from the time of reporting of a patient till ten days post discharge medication, including complications if any up to thirty (30) days post-discharge, for those patients who undergo a "listed therapy (ies). Free OP evaluation of patients for listed therapies who may not undergo treatment for "listed therapies. All the pre-existing cases under listed therapies are covered under the scheme. Food and Transportation.
  • Network Hospitals Coverage: As of now the scheme is being implemented in 523 hospitals (Govt. Hospital - 152 and Corporate Hospitals - 371)

CMCO Centers
  • Hyderabad Center In order to facilitate poor patients who do not possess white card (BPL ration card) , Government established CMCO referral center at the Camp Office of Hon'ble Chief Minister. These patients shall physically approach the CMCO center with proof of residence and medical records to these centers. Temporary referral card with the photograph of the patient with 10 days validity will be issued to the patient to enable to undergo cashless treatment in a network hospital for identified diseases under Dr.NTR Vaidya Seva Scheme.
  • Peripheral Centers Five (5) CMCO peripheral centers at Kurnool, Kakinada, Visakhapatnam, Vijayawada and Tirupati were established by Trust to issue CMCO referral cards to the eligible patients to undergo cashless treatment under the scheme with certain guidelines to facilitate poor patients living in districts.

Cochlear Implant Program: Financial assistance is provided to the children of BPL families born totally deaf and dumb to undergo cochlear implantation surgery and Audio-Verbal therapy under the Scheme. Children below 2 years of age are eligible for pre-lingual deafness and children below 12 years of age are eligible for post lingual cases. Financial coverage is Rs.6.50 lakh for each child and the services provided are Cochlear Implant Surgery ii. Audio-Verbal therapy for one year period

Follow-up Services: Follow-up services are provided for a period of one year through fixed packages to the patients whoever requires long term follow-up therapy in order to get optimum benefit from the procedure and avoid complications. Follow-up package for consultation, investigations, drugs etc., for one year for 125 listed therapies were formulated by Technical committee of the Trust in consultation with specialists.

Emergency Registration and Admission: Emergency Registration and Admission All the beneficiaries shall be admitted by a NWH and treated immediately. MEDCO or treating doctor shall obtain emergency telephonic pre-authorisation through dedicated round the clock telephone lines of the Trust, if the patient is suffering from listed therapies.

Health Camp Services: The benefit in the primary care is addressed through health camps as part of scheme implementation. Health Camps are main source of mobilizing the Beneficiaries. The important role played by the health camps includes conducting IEC [Information, Education and Communication] activity, screening, counselling , treatment of common ailments and refer the patients to Government and Corporate Network Hospitals for treatment under Dr.NTR Vaidya Seva.

Complaints and Grievance redressal: A comprehensive complaint cell and grievance redressal mechanism is put in place through online system with clear TAT's (Turnaround Times) in order to ensure fair and timely redressal of grievances received from various sources. These complaints and grievances are monitored at the highest level in the Trust on daily basis

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Contact Information

Special Chief Secretary to Govt.,
Health, Medical & Family Welfare Dept.
5th Block,Ground Floor,Room No:157,
A.P Secretariat,Velagapudi,
Guntur Dt., Andhra Pradesh.