Bhubaneswar, Odisha – In a landmark initiative to overhaul healthcare accessibility, the Odisha government, led by Chief Minister Shri Naveen Patnaik, has rolled out the Biju Swasthya Kalyan Yojana (BSKY). This scheme is a beacon of hope, aiming to provide all-encompassing health coverage, particularly for the economically vulnerable and women in the state.
Quick Facts & Figures: Biju Swasthya Kalyan Yojana Scheme
| Aspect | Details |
|---|---|
| Scheme Name | Biju Swasthya Kalyan Yojana (BSKY) |
| Initiative By | Odisha Government, led by Chief Minister Shri Naveen Patnaik |
| Objective | To provide universal health coverage, especially for economically vulnerable families and women |
| Coverage | Two components: State Government Hospital Coverage and Private Hospital Coverage |
| Eligibility | All Odisha residents for government services; BSKY Smart Health Card, NFSA, SFSS cardholders for private services |
| Enrollment Process | Automatic for NFSA/SFSS families; BSKY Smart Health Cards distributed by the government |
| Health Coverage | Rs. 5 lakh per annum per family, additional Rs. 5 lakh for women members in private hospitals |
| Benefits | Cashless healthcare services including in-patient and day care treatments |
| Key Feature | Annual coverage refresh without the need for card renewal |
| Claims Process | Pre-authorization required for treatments above Rs 10,000; claims uploaded within 7 days of discharge |
| Documents for Enrollment | Valid NFSA or SFSS card |
| Documents for Service Access | BSKY Smart Health Card or NFSA/SFSS card, Aadhaar details |
| Renewal Process | No renewal required; coverage amount refreshed annually |
| Grievance Redressal | Dedicated BSKY call center and feedback systems |
Understanding Biju Swasthya Kalyan Yojana: A Two-Pronged Approach
BSKY operates on two fundamental components:
- State Government Hospital Coverage: This facet guarantees cashless healthcare for every citizen in State Government hospitals, irrespective of their economic background.
- Private Hospital Coverage: It extends similar benefits to economically vulnerable families in empanelled private hospitals, offering an annual health coverage of Rs. 5 lakh per family, with an additional Rs. 5 lakh earmarked for women members.
Eligibility and Enrollment: Simplified and Inclusive
The eligibility criteria are designed to be inclusive:
- For Government Hospital Services: All residents of Odisha are automatically eligible.
- For Private Hospital Services: Holders of the BSKY Smart Health Card, along with NFSA or SFSS cardholders, are eligible. Enrollment is automatic for NFSA/SFSS families, who receive the BSKY Smart Health Cards without any need for a separate application process.
Comprehensive Benefits: A Closer Look
The scheme’s benefits are extensive and meticulously planned:
- Annual Coverage Refresh: The BSKY Smart Health Card, with no need for renewal, refreshes its coverage amount annually.
- Inclusive Treatment Packages: It covers a wide range of in-patient and day care treatments, detailed in an accessible package list on the BSKY website.
- Streamlined Authorization and Claims: The scheme outlines a clear pre-authorization process for specific treatments and an efficient claim settlement process, ensuring transparency and ease for beneficiaries.
Biju Swasthya Kalyan Yojana (BSKY): A Closer Look at Key Components
BSKY Card & Registration Process
- BSKY Smart Health Card: This card is central to the scheme, acting as a gateway to access the benefits.
- Automatic Enrollment: Families covered under the National Food Security Act (NFSA) or the State Food Security Scheme (SFSS) are automatically enrolled.
- Card Distribution: The government distributes BSKY Smart Health Cards to eligible families. These cards can also be collected at designated Mo Seva Kendras by presenting valid NFSA/SFSS cards.
- Real-Time Synchronization: The BSKY database is updated in real-time with NFSA/SFSS data, ensuring up-to-date beneficiary information.
Eligibility Criteria
- For State Government Hospital Services: All residents of Odisha are eligible for cashless healthcare services.
- For Empanelled Private Hospital Services: Eligibility extends to BSKY Smart Health Card, NFSA, and SFSS cardholders. This includes cashless health coverage of Rs. 5 lakh per annum per family, with an additional Rs. 5 lakh for women members.
Documents Required for BSKY
- For Enrollment: Valid NFSA or SFSS card.
- For Service Access: BSKY Smart Health Card or NFSA/SFSS card. Aadhaar number and demographic details are also stored on the chip of the BSKY Smart Health Card.
Claims Settlement Process of BSKY
- Pre-Authorization: Required for procedures with a package cost of Rs 10,000 or more and all cases under the тАЬUnspecifiedтАЭ category.
- Turn Around Time (TAT): The TAT for preauthorization is 24 hours for package costs of Rs. 10,000 or more. For тАЬUnspecifiedтАЭ packages, it’s 48 hours.
- Auto-Approval: If a decision on preauthorization is not taken within the specified TAT, it is auto-approved by the BSKY application.
- Claim Settlement: Claims need to be uploaded in the BSKY application within 7 days of discharge. Payment is made through electronic transfer within four weeks of raising the claim.
Documents Required for Making a Claim
- Minimum Required Documents: As specified in the package master for the settlement of claims.
- Timely Submission: Documents must be uploaded within 7 days of patient discharge. Delayed submissions lead to claim rejection.
Why BSKY Matters: Impact on Public Health
BSKY is more than just a healthcare scheme; it’s a movement towards equitable health services. By eliminating financial barriers, it ensures that quality healthcare is a right, not a privilege, for every Odisha citizen.
Operational Excellence: Infrastructure and Grievance Redressal
The scheme is underpinned by robust infrastructure and operational guidelines:
- Hospital Empanelment and Incentives: Detailed processes for private healthcare provider empanelment and hospital incentives ensure quality service delivery.
- IT Infrastructure: Specific IT infrastructure requirements are laid out for the smooth functioning of the scheme in empanelled hospitals.
- Grievance Mechanism: A dedicated BSKY call center and feedback systems ensure that grievances and feedback are addressed promptly and effectively.
The Road Ahead: Setting a Precedent in Healthcare
As BSKY unfolds across Odisha, it sets a benchmark for healthcare initiatives in India, demonstrating the profound impact of government intervention in public health. It reflects the government’s unwavering commitment to the ethos, “Every life is precious.”
A comprehensive visual representation of the BSKY scheme, including images of beneficiaries using the Smart Health Card, healthcare facilities under the scheme, and a graphical representation of the coverage benefits
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Dive deep into Odisha’s Biju Swasthya Kalyan Yojana, a pioneering scheme offering universal health coverage. Explore its eligibility criteria, benefits, and application process in our detailed report.
Frequently Asked Questions about Biju Swasthya Kalyan Yojana (BSKY)
What is the Biju Swasthya Kalyan Yojana (BSKY)?
BSKY is a health welfare scheme launched by the Odisha government, aimed at providing universal health coverage, especially for economically vulnerable families and women. It includes cashless healthcare services in both government and empanelled private hospitals.
Who is eligible for BSKY?
All residents of Odisha are eligible for cashless healthcare services in state government hospitals. For private hospital services, BSKY Smart Health Card, NFSA, and SFSS cardholders are eligible.
How can I enroll in BSKY?
Enrollment in BSKY is automatic for families covered under the National Food Security Act (NFSA) or the State Food Security Scheme (SFSS). Eligible families are provided with a BSKY Smart Health Card.
What is the BSKY Smart Health Card?
The BSKY Smart Health Card is a key component of the scheme, acting as proof of eligibility for beneficiaries. It contains details like the names of family members, age, gender, Aadhaar numbers, and a unique smart card number.
What kind of healthcare coverage does BSKY provide?
BSKY provides cashless healthcare services, including in-patient and day care treatments. The scheme covers a wide range of treatments, with specific packages listed on the BSKY website.
What is the claims settlement process in BSKY?
Claims under BSKY require pre-authorization for treatments costing Rs 10,000 or more. Claims need to be uploaded in the BSKY application within 7 days of patient discharge, with payment made through electronic transfer within four weeks.
What documents are required for BSKY?
For enrollment, a valid NFSA or SFSS card is required. For accessing services, the BSKY Smart Health Card is needed. For making a claim, specific documents as listed in the package master are required.
Is there a renewal process for the BSKY Smart Health Card?
No, the BSKY Smart Health Card does not require renewal. The coverage amount is refreshed annually.
Can I use the BSKY Smart Health Card in private hospitals?
Yes, the card can be used in empanelled private hospitals for cashless healthcare services, as per the scheme’s guidelines.
How can I address grievances related to BSKY?
For grievances, beneficiaries can contact the dedicated BSKY call center. The scheme also has a feedback system for addressing issues related to healthcare services under BSKY.
