NWH Obligations

Reception

NWH shall place EHS Kiosk at the reception or at the patient entry point to the NWH as decided by the Trust for the purpose of reception and registration. It shall provide 2 MBPS Net connection and dedicated computer with peripherals. NWH shall identify, direct and register all the patients holding eligibility card.

Free pre-evaluation

All the beneficiaries shall be pre-evaluated for the listed therapies till the diagnosis is established.

Counseling for packages where facilities are unavailable

The patient shall be properly counselled and referred to nearby NWH for further management, if found to be suffering from diseases other than those that cannot be managed in the NWH.

Admission and Pre-Authorisation

The beneficiary shall be admitted as per the medical requirement and before pre-authorisation.

NWH shall send pre-authorisation for all the cases suffering from listed therapies after the final diagnosis and treatment plan along with the required documentation.

Treatment

NWH shall offer complete treatment to the beneficiary as per the standard medical practices choosing best possible mode of treatment.

NWH shall use standard and approved medications, implants and other inputs. NWH shall attend to all the complications arising out during the course of hospitalization and make efforts to complete the treatment irrespective of costs incurred.

Discharge

NWH shall discharge the patient after satisfactory recovery, duly giving discharge summary.

NWH shall give ten days post discharge medication, as per the scheme norms and counsel the patient for follow-up.

Follow up

NWH shall provide follow-up treatment for identified listed therapies under the scheme.

Management of Complications

  1. During hospitalization:NWH shall attend to all the complications arising during the course of treatment in the hospital.
    1. Related complications: NWH shall attend to all the related Complications, re-do surgeries within the package price.
    2. Unrelated complications: NWH may obtain pre-authorisation for unrelated complications due to underlying co-morbid conditions, if the said complication is among listed therapies or may apply for package price enhancement.
  2. After hospitalization
    1. Related complications: NWH shall attend to all the complications related to the primary treatment up to the period of one month from date of discharge within the package price.
    2. Unrelated complications: NWH may obtain pre-authorisation for unrelated complications due to underlying co-morbid conditions, if the said complication is among listed therapies
    3. NWH may counsel and refer the patient to the nearest Govt. Hospital for unrelated complication not in listed therapies.

Quality of Services

NWH shall follow the standard medical protocols and use only approved medications, implants and other inputs to ensure quality treatment. NWH shall follow the best medical practices as per the standard medical practices and ensure quality of services for the best outcome of the treatment. The hospital may establish internal medical audit mechanism for the above purpose.

MEDCO Services

NWH shall provide MEDCO services as specified in Term No 9.6.

Health Camps

NWH shall provide health camps in Government Offices as and when required.

Cashless Service

  1. The beneficiaries are provided with cashless treatment with adequate facilities without the need to pay any deposits right from the entry into the hospital, the commencement of the treatment, the end of treatment till the expiry of 10 days post discharge, for all the procedures covered under the Scheme.
  2. It is envisaged that for each hospitalization the transaction shall be cashless for covered procedures. Enrolled beneficiary will go to hospital and come out without making any payment to the hospital subject to procedure covered under the scheme.
  3. The same is the case for diagnostics if eventually the patient does not end up in doing the surgery or therapy.

Limitation of liability and indemnity

  1. The NWH shall be responsible for all commissions and omissions in treating the patients referred under the scheme and will also be responsible for all legal consequences that may arise. Trust will not be held responsible for the choice of treatment and outcome of the treatment or quality of the care provided by the NWH and should any legal complications arise and is called upon to answer, the NWH will pay all legal expenses and consequent compensation, if any.
  2. The NWH admits and agrees that if any claim arises out of` alleged deficiency in service on their part or on the part of their men or agents, then it will be the duty of the NWH to answer such claim. In the unlikely event of Trust being proceeded against for such cause of action and any liability was imposed on them, only by virtue of its relationship with the NWH and then the NWH will step in and meet such liability on their own.
  3. The mere Preauthorization approval of case by Trust or insurer based on the data provided by the Network Hospitals shall not be construed as final medical opinion with regards to Diagnosis & Treatment of choice. The treating Doctor & Network hospital shall be solely responsible for the final diagnosis of disease, choice of treatment employed and outcome on such treatment.
  4. NWH admits and agrees that if any claim, suit or disciplinary actions by Empanelment and Disciplinary Committee (EDC) arises due to any commissions or omissions of their employees including MEDCO, Billing Head, Data Entry Operator or employees outsourced by them, NWH will be liable for such claim or suit or Disciplinary action.

Confidentiality

  1. All the stakeholders undertake to protect the secrecy of all the data of beneficiaries and trade or business secrets of and will not share the same with any unauthorized person for any reason whatsoever within or without any consideration.
  2. The NWH agrees to protect the confidentiality of the patient data including that of the clinical photographs and take due care to follow the standard medical practices while obtaining such photographs, under any circumstances Trust cannot be held responsible for lapse in confidentiality and protecting the information of the patient in the hospital.
  3. The NWH undertakes to handle the patient data diligently and shall not share or give access to employees of the hospital or to the outsiders under any circumstances within the hospital or outside.