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Scrutiny of OPD/ IPD Claims at RC Level: ECHS

Scrutiny of OPD/ IPD Claims at RC Level: ECHS Central OrganisationECHS  Adjutant General's Branch  Integrated HQ of MoD (Army) 

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Scrutiny of OPD/ IPD Claims at RC Level: ECHS
Central OrganisationECHS 
Adjutant General’s Branch 
Integrated HQ of MoD (Army) 
Maude Lines 
Delhi Cantt- 110 010 
B/ 49779-Outsourcing/ AG/ ECHS/ Policy 
12 Jul 2018 
All Regional Centres 
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SCRUTINY OF OPD/IPD CLAIMS AT RC LEVEL 

1. Further to our letter No B/ 49779-Outsourcing/ AG/ ECHS/ Policy dated 10 Nov 2017, pursuant to the instructions received from DoESW vide letter No. 18(80) / 2017/WE/ D(Res-1) dated 12 Jul 2018 and proposal to formalize second tier check vide case file No B/ 49779- Outsourcing/ AG/ ECHS initiated on 06 Jul 2018. 

2.It is directed that the process for online bill processing at RC level to be carried out as under:- 
    (a)BillsAmountingtoLessthanRs30,000/ –. For bills amounting to lessthan Rs. 30,000/ -, 2% bills per day shall be checked by the JD (HS). The billsselected will be those havinghighestfinancialvalue.Additionalbillscanbe checkedasper discretion. 
    (b) Bills in the Rangeof Rs30,000/ -toRs59,999/ –. For bills in the rangeof Rs 30,000/ – to 59,999/ -, 3% bills per day shall be checked by the JD (HS). Thebills selected will be those having highest financial value. Additional bills can bechecked as per discretion. 
    (c) Bills in the Rangeof Rs60,000/ -toRs99,999/ –. For bills in the rangeof Rs 60,000/ – to 99,999/ -, 5% bills per day shall be checked by the JD (HS). Thebills selected will be those having highest financial value. Additional bills can bechecked as per discretion. 
    (d) Bills Morethan Rs1 Lakh. 100% Bills for amount more than Rs. 1 Lakh to be checked by JD(HS) at RC. 
3. The process to be put in effect immediately and respective functionaries in the Online Bill Processing chain to ensure that the above is complied. 

4. The modification incorporated in the system of the online bill processing application will be such that a basket of 100 claims is presented to the JD(HS), those 100 claims will be picked up in FIFO manner out of the claims processed by BPA. There will be separate baskets for OPD, IPD and individual re-imbursement claims. The 100 claims in each basket will be strictly presented in FIFO manner. The presentation of these baskets to JD(HS) and its subsequent manner of processing for all baskets (OPD, IPD and individual re-imbursement) is described below:- , 
    (a)Claims less than Rs. 30,000/ –. These will be listed on top of the page and JD(HS) would have to compulsorily check 2% of such claims (number to be rounded off to the next round figure). These claims would be the one’s with the highest recommended amount. The multi select option for the balance claim in this category would be available orally after atleast 2% claims have been checked. JD(HS) can check additional claims also as per his discretion. 
    (b) Claims between Rs. 30.000/ – to Rs. 59,999/-. A counter for the claims falling in this region would be created by BPA to reflect 3% of such claims ,(number to be rounded off to the next round figure) which would have to be compulsorily checked by the JD(HS). These claims would be the one’s with the highest recommended amount. The JD(HS) would ha’ve the option to check any additional claim also should he choose to do so. The multi select option for the balance claim in this category would be available only after atleast 3% claims have been checked. 

    (c) Claims between Rs. 60,000/ – to Rs. 99,999 / -. A counter for the claims falling in this region would , be created by BPA to reflect 5% of such claims (number to be rounded off to the next round figure) which would have to be compulsorily checked by the JD(HS). These claims would be the one’s with the highest recommended amount. The JD(HS) would have the option to check any additional claim also should he choose to do so. The multi select option for the balance claim in this category would be available only after atleast 5% claims have been checked. 
    (d) Claims above Rs. 1 Lakh/-. All claims above Rs. 1 Lakh will have to be compulsorily checked by JD(HS). No multi select option will be enable? in this window. 

5. Next set of 100 claims in the concerned basket will be presented to the JD(HS) only after the claims in the respective basket has been completely cleared. 
6.In addition, it is highlighted that in accordance with Para 2(d) of MoD letter No. 22(A)(10/ 10/ US(WE)(Res) dated 23 Feb 2012, “CFA will examine the bill and BPA’s worksheet prior to according sanction,,.” Hence, all CFAs must ensure that no violation to the above guidelines take place and ‘the provisions brought out above are not compromisedinany manner. 
7. Please ensure speedy clearance of bills so that large pendencies can be reduced. Financial integrity of checks, will not be compromised. 
8. These instructions are issued with approval of MD ECHS.1 
(DM Anand)
Col 
Dir (Stats & Automation)
for MD ECHS 

Source: Click here to view/download the PDF
[https://echs.gov.in/img/Scrutiny%20of%20OPD%20IPD%20claims%20at%20RC%20level.pdf]

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