My father was treated under the Ayushman Bharat scheme, and the process was cashless. I’m curious about the back-end process. How long does it take for the hospital to actually receive the money from the government?
For a beneficiary, the Ayushman Bharat scheme provides an instant and cashless experience, so there is no personal “claim settlement” period. For the empanelled hospital, the process of getting the claim settled by the government is designed to be quick, with a general timeline of about 15 days.
The Beneficiary’s Experience: Cashless and Instant
I was discussing this with a friend whose mother was recently discharged from a private hospital after a surgery covered by the Ayushman card. He confirmed that from his family’s perspective, there was no waiting period for settlement. The entire process was cashless from admission to discharge. The financial transaction was handled entirely between the hospital and the government, without his involvement.
The Hospital’s Claim Submission Process
The Ayushman Mitra at the hospital had explained the back-end process to my friend. He said that after the patient is successfully treated and discharged, the hospital’s billing department compiles all the necessary documents, such as the discharge summary and test reports. They then submit a formal claim for the pre-approved package amount through the official PM-JAY online portal.
The Official Timeline for Claim Settlement
I spoke to a hospital administrator about this to understand the timeline. She confirmed that the National Health Authority has set a clear Turnaround Time (TAT) for payments. Once a hospital submits a clean claim with all the correct documents, the government and the insurance companies are mandated to process and settle the payment to the hospital within 15 days. She mentioned that this prompt and defined payment schedule is a key reason many private hospitals have joined the scheme.
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