Principal Controller of Defence Accounts has pointed out common
defects in the Medical Bills submitted in respect of Defence Civilians
(Non DAO)
During scrutiny/ audit of medical reimbursement claim the following observations are communally observed:-
1. Scrutiny certificate not found enclosed
2. Check list, MEO 2004/97/MRCs not attached/ not completed along with date and signed/ not countersigned
3. The specimen signature of competent authority not available or does not tally with the sample specimen signature.
4. The attested photocopy of CGHS card along with
family photograph/ family detail with D.O.B. not enclosed/not
verified by unit authority.
5. Original Discharge/Emergency Certificate of the hospital in admission cases not enclosed.
6. The referral letter from CGHS dispensary not enclosed.
7. Original bills not attached or duplicate
bills attached without certificate of lost vouchers as specified
In FR-II RULE 43 and affidavit, for duplicate claim, on stamp paper.
8. The CGHS Package deal/ CGHS Package no. For Pathological test not mentioned.
9. Original Discharge/Emergency certificate of the hospital In admission cases not enclosed.
10. Time barred sanction by Competent Authority (HOD) in case delay by more than one month/three month from date of discharge/treatment (in case of med advance).
11. Legal heir affidavit on stamp paper for
claiming medical reimbursement claim along• with no objection
certificate on stamp paper in case of death of card holder not
enclosed.
12. 10% discount may be obtained from the
hospital on the final bill on cash payment/advance taken from
Govt as per MOA signed by the each hospital with.
13. In IOL implantation the sticker ID not attached / verified by operating surgeon along with name & type of IOL lens and the cash receipt.
14. All test copy may be enclosed.
15. The claim may please be forwarded to
Addl Director, CGHS (as per letter s-11012/91-CGHS(P) (Vol-I) dt
18/03/1992 para 3(xiii)).
16. Certified copy of Emergency Certificate is not found enclosed.
17. The pay slip of the employee showing pay in pay band and grade pay is not found enclosed for assessment of entitlement.
18. As per this Office Circular
No.Pay/lv/Med/7007/0rd dt 23/05/2014 medical bill/final bill of
hospital concerned (raised on or after 01/07/2014) received without
printed PAN, TAN, TIN would not be entertained.
19. After discharge the CGHS reference is not enclosed for follow up treatment.
20. Intimation within 24 hours to concerned unit
and CGHS wellness centre regarding emergency admission in hospital has
not been found attached.
21. Heavy medicines have been tendered to the
patient; therefore the amount of medical claim paid to the
individual/hospital may please be assessed by Addl Dire CGHS
(concerned city).
22. The CGHS doctor has not verified the (ATP) Cash
Memos (ADD. DIR. CGHS LUCKNOW Letter N0.3-151/2013-CGHS/LKO Dot
30/09/2013).