Common use of Identification of Beneficiaries Clause in Contracts

Identification of Beneficiaries. The beneficiaries presenting themselves to the EHCP will be identified by the EHCP on the basis of a Beneficiary Identification System (BIS). The details of BIS have been provided in Annex 3. The EHCP agrees to conform to the following for effective implementation of BIS. The EHCP will set up a help-desk for beneficiaries within 7 days of signing of this agreement. The help-desk must be situated in the facility of the EHCP in such a way that it is easily visible, easily accessible to the beneficiaries. The help desk will be equipped with all the necessary hardware and software as well as internet connectivity as required by BIS to establish the identity of the AB PM-XXX beneficiary. Specifications of necessary hardware and software have been provided in Annex 3. The help desk shall be manned by an Arogya Mitra (AM) for facilitating the beneficiary in accessing the benefits. Arogya Mitra will need to be hired by the private EHCP at their own cost and they should get them trained before starting the operations. The guidelines for engagement of Arogya Mitras are provided in Annex 4. The EHCP shall ensure that if the Arogya Mitras or any other personnel of EHCP suspects or detects any beneficiary fraud, it shall be incumbent upon them to immediate inform the SHA in writing with all particulars of the beneficiary and reasons for suspecting fraud. The EHCP hereby agrees that is shall be obliged to ensure that beneficiary identification is done with adequate due diligence by the Arogya Mitras employed by the EHCP so that only eligible beneficiaries are admitted for services and cashless treatment under the Scheme and to rule out errors/omissions or mala-fide actions like impersonation etc. with or without connivance of various parties. If at a later date it is found that an ineligible person was extended treatment under the scheme, whether pre-authorization obtained or not, the SHA shall not be liable to reimburse claims of such beneficiaries; and if such claim has been paid by the SHA, the SHA shall have the right to seek recovery from the EHCP through means available under this Agreement and under Applicable Laws.

Identification of Beneficiaries. The beneficiaries presenting themselves to the EHCP will be identified by the EHCP on the basis of a Beneficiary Identification System (BIS). The details of BIS have been provided in Annex 3. The EHCP agrees to conform to the following for effective implementation of BIS. 1. The EHCP will set up a help-desk for beneficiaries within 7 days of signing of this agreement. The help-desk must be situated in the facility of the EHCP in such a way that it is easily visible, easily accessible to the beneficiaries. 2. The help desk will be equipped with all the necessary hardware and software as well as internet connectivity as required by BIS to establish the identity of the AB PM-XXX beneficiary. Specifications of necessary hardware and software have been provided in Annex 3. 3. The help desk shall be manned by an Arogya Mitra (AM) for facilitating the beneficiary in accessing the benefits. Arogya Mitra will need to be hired by the private EHCP at their own cost and they should get them trained before starting the operations. The guidelines for engagement of Arogya Mitras are provided in Annex 4. 4. The EHCP shall ensure that if the Arogya Mitras or any other personnel of EHCP suspects or detects any beneficiary fraud, it shall be incumbent upon them to immediate inform the SHA in writing with all particulars of the beneficiary and reasons for suspecting fraud. 5. The EHCP hereby agrees that is shall be obliged to ensure that beneficiary identification is done with adequate due diligence by the Arogya Mitras employed by the EHCP so that only eligible beneficiaries are admitted for services and cashless treatment under the Scheme and to rule out errors/omissions or mala-fide actions like impersonation etc. with or without connivance of various parties. If at a later date it is found that an ineligible person was extended treatment under the scheme, whether pre-authorization obtained or not, the SHA shall not be liable to reimburse claims of such beneficiaries; and if such claim has been paid by the SHA, the SHA shall have the right to seek recovery from the EHCP through means available under this Agreement and under Applicable Laws.

Identification of Beneficiaries. The beneficiaries presenting themselves to the EHCP will be identified by the EHCP on the basis of a Beneficiary Identification System (BIS). The details Identification of BIS have been provided in AB-MGRSBY Beneficiary Family Units will be done as per Clause 7 and Annex 32.4 of Volume II of RFP and scheme guidelines. The Further the EHCP agrees to conform to the following for effective implementation of BIS. The EHCP will set up a help-desk for beneficiaries within 7 days of signing of this agreement. The help-desk must be situated in the facility of the EHCP in such a way that it is easily visible, easily accessible to the beneficiaries. The help desk will be equipped with all the necessary hardware and software as well as internet connectivity as required by BIS to establish the identity of the AB PM-XXX AB- MGRSBY beneficiary. Specifications of necessary hardware and software have been provided in Annex 3. The help desk shall be manned by an Arogya Mitra Swasthya Margdarshak (AMSM) for facilitating the beneficiary in accessing the benefits. Arogya Mitra SM will need to be hired by the private EHCP at their own cost and they EHCP should get them the SM trained before starting the operations. The guidelines for engagement of Arogya Mitras SMs are provided as below- Swasthya Margdarshak (SM) will need to be hired by Private EHCP for managing the help desk. Public EHCP to follow the guidelines issued by RSHAA for Swasthya Margdarshak. This help desk will need to be set up exclusively for AB- MGRSBY. Indicative role of SM is as follows:- Guide beneficiary regarding AB-MGRSBY and process to be followed in Annex 4. The EHCP shall ensure that if the Arogya Mitras or any other personnel of EHCP suspects or detects any beneficiary fraud, it shall be incumbent upon them to immediate inform the SHA in writing with all particulars of the beneficiary and reasons for suspecting fraud. The EHCP hereby agrees that is shall be obliged to ensure that beneficiary identification is done with adequate due diligence by the Arogya Mitras employed by the EHCP so that only eligible for taking the treatment Carry out the process of Beneficiary Identification for such persons who are beneficiaries are admitted for services and cashless treatment under of AB-MGRSBY Take the Scheme and to rule out errors/omissions or mala-fide actions like impersonation etc. with or without connivance of various parties. If at a later date it is found that an ineligible person was extended treatment under the scheme, whether pre-authorization obtained or not, authorisation as and when required as per the SHA shall not be liable RFP/Scheme guidelines In time submission of claims to reimburse claims of such beneficiaries; and if such claim has been paid Insurance Company. Timely reply to the queries raised by the SHA, the SHA shall have the right to seek recovery from the EHCP through means available under this Agreement and under Applicable LawsInsurance Company.