ABPMJAY-MEGHA HEALTH
INSURANCE SCHEME

The Hospital has a designated MHIS office strategically located to ensure easy and convenient access for both patients and staff.

    This helps:
  • Streamline Workflows
  • Improve Service Efficiency
  • Support a smoother communication process between departments

The MHIS Office has 7 Counters for BIS Enrollment,TMS Registration & Discharge and Helpdesk for Scheme Enquiries. The Scheme is implemented under the guidance of The Medical Superintendent (Jt DHS) & The Nodal Officer (In charge) MHIS.

Benefits

    Benefits include:
  • ₹5,00,000 coverage per family per year
  • ₹30,000 insurance coverage for OPD

All residents of Meghalaya are entitled, excluding State and Central Government employees who are entitled under the State/Central reimbursement policy. There is no restriction on the family size under the scheme. There is no age limit under the scheme.

OPD Benefits IPD Benefits
OPD includes coverage for
  • Maternity benefits, (Antenatal care)
  • Follow-up-care benefits. (Postnatal Care)
  • OPD diagnostic (Ultrasound)
  • Child care benefits
  • Cardiac and diabetes preventive care benefits.
IPD includes coverage for
  • Maternity benefits, (Antenatal care)
  • Follow-up-care benefits. (Postnatal Care)
  • Child care benefits
  • Cardiac and diabetes preventive care benefits.
  • Coverage of all critical ward charges (provided the amount does not exceed the package amount).
  • Coverage of all Lab charges
  • Coverage of all medicines
  • TIE UP for HPE, CERVICAL SCREEN, MRI & CT SCAN and XRAY SERVICES

Manpower

Designation No. of Staffs
Programme Manager cum Accountant 1
Accountant Assistant 1
PMAM 9
Ayush Mitra-Grade IV 4
Pharmacist 4

PMAM/MEDCO - BIS/TMS OPERATORS

The MHIS office has 9 PMAMs that operate the TMS (Transaction Management System) and BIS (Beneficiary Information System), crucial for claims processing and management.

    PMAM roles:
  • Enroll Beneficiary in BIS portal
  • Link aadhaar with beneficiary card
  • Register the beneficiaries in TMS at Counters or bedside (wards)
  • Co-ordinate with Doctors for package blocking and queries reply
  • Work closely with Staff nurses to collect necessary document & reports
  • Share registered MHIS beneficiary list with DEO to uploading in the Hospital Management software for billing purposes.
  • Capture Biometric and Photo at Discharge
  • Ensure the Discharge Summary & medical Reports are scanned
  • Store patient documents in a folder-based system to ensures easy retrieval and efficient record-keeping for audits and future reference.

AYUSHMAN MITRAS - Grade IV Staffs

The MHIS office has 4 Ayushman Mitras (Grade IV Staffs) whose role are:

  • Identify eligible beneficiaries
  • Facilitating the proper targeting and inclusion of participants in the scheme
  • Scan documents of patients for New registration, Enhancement, Blocking package, OT List
  • On bed photo of patients

Registration Process

Post Registration Process

After a patient has been successfully registered, the following steps are carried out.

  • Wristband Issuance: Orange Wristband is provided to Registered patients
  • Case sheet Processing: Each casesheet is stamped with the MHIS seal to confirm MHIS registration.
  • Form Attachment for MHIS Identification: Registered form attached to the casesheet for MHIS beneficiaries - Blue Form/Pink Form(SNCU). These initiatives help hospital staff easily identify MHIS beneficiaries.

Stratergy to Cashless Benefits

  • 24*7 MHIS IN HOUSE PHARMACY - No cash Transaction
  • COVERAGE of ICU charges & LAB charges
  • TIE UP for HPE, CERVICAL SCREEN, MRI & CT SCAN and XRAY SERVICES

Card Generartion and Aadhar Linkage Process

Accreditation

    The hospital has been awarded with
  • NQAS & MUSQAN CERTIFICATE- Awarded recently October 2025
  • B-PMJAY BRONZE CERTIFICATE - Awarded in June 2025
  • LAQSHYA CERTIFICATION FOR LABOUR ROOM - Awarded in 2024
  • LAQSHYA CERTIFICATION FOR OPERATION THEATRE - Awarded in 2023

Impact of MHIS Scheme on Quality Improvement

    Funds generated through the MHIS/AB-PMJAY scheme play a crucial role in:
  • Filling critical resource and infrastructure gaps
  • Enhancing patient care services
  • Ensuring continuous quality improvement
  • Supporting staff training and capacity building