CMCHIS Empanelled Hospitals in Chennai: A Guide for Beneficiaries

The Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS), a flagship initiative of the Tamil Nadu government, aims to provide accessible and quality healthcare to eligible families across the state. By offering financial protection against high medical expenses, the scheme ensures that beneficiaries can receive necessary treatments without facing a crippling financial burden. The core of the scheme is a cashless system, where the government directly pays the hospital for the approved procedures, allowing patients to focus on their recovery rather than on arranging funds.

This system operates through a vast network of both government and private hospitals that have been approved and 'empanelled' to provide services under CMCHIS. For residents of Chennai, understanding which hospitals are part of this network is crucial for accessing these benefits. Whether it's for a planned surgery or an unexpected medical emergency, knowing where to go can save valuable time and prevent confusion. The scheme covers a wide array of treatments, from common surgeries to more complex procedures, making it a vital resource for millions.

This guide serves as a practical resource for CMCHIS beneficiaries in Chennai. It provides a list of empanelled government and private hospitals within the city, compiled from official sources. Furthermore, it outlines the steps to avail cashless treatment, the documents you will need to carry, and what to do in case you face any issues at an empanelled facility. By equipping yourself with this information, you can navigate the healthcare system more effectively and make full use of the benefits provided by the Tamil Nadu government.

Empanelled Government Hospitals in Chennai

This list is not exhaustive. Please check the official CMCHIS portal for the complete and most current list of empanelled government facilities.

• Government Kilpauk Medical College — Kilpauk
• Government Royapettah Hospital — Royapettah
• Government Stanley Medical College — Chennai
• Madras Medical College — Chennai

Empanelled Private Hospitals in Chennai

Hospital empanelment status can change. Beneficiaries are advised to verify the current status on the official CMCHIS website before seeking treatment.

• Abhijay Hospital (P) Ltd. — Peravallur [Perambur]
• Apollo Children's Hospital — Thousand Lights
• Apollo Greams — Chennai
• Billroth Hospital — Shenoy Nagar
• C.S.I. Kalyani Hospital — Dr. R.K.Salai
• Cancer Institute (WIA) — Adyar
• Dr. Rai Memorial Cancer Institute — Teynampet
• Fortis Malar Hospital — Gandhi Nagar, Adyar
• Geri Care Hospital — T. Nagar
• Global Hospitals & Health City — Perumbakkam
• Hande Hospital — Shenoy Nagar
• KKR ENT Hospital and Research Institute — Chennai
• Kumaran Hospital Kilpauk — Kilpauk
• Madras ENT Research Foundation — Chennai
• Noble Hospital — Purasawalkam
• Parvathy Ortho Hospital — Chennai
• Sankara Nethralaya — Chennai

Rates shown are as per the Official CMCHIS Portal (2024) and are subject to periodic revision. Always verify the latest approved rates on the official source.

How to Use Your CMCHIS Card at an Empanelled Hospital

Accessing cashless treatment at a CMCHIS-empanelled hospital in Chennai is a structured process. The first step is to identify and visit a hospital from the approved list. Upon arrival, you should locate the dedicated CMCHIS desk or kiosk, which is usually present in all empanelled facilities. Present your CMCHIS e-card to the hospital representative at this desk.

The hospital staff will then verify your identity and the validity of your card using their online portal. Once your eligibility is confirmed, the hospital will initiate a pre-authorisation request with the insurance company managing the scheme. This request includes your diagnosis and the proposed treatment plan. For planned procedures, this should be done before admission. In case of an emergency, the hospital will begin treatment while simultaneously seeking authorisation.

After the treatment is complete, the hospital will submit all the necessary documents, including medical bills and discharge summaries, to the insurer for settlement. The patient or their family does not need to pay for any covered procedures. Your primary responsibility is to ensure you have your card and a valid ID, and to sign the required forms at the time of admission and discharge.

Essential Documents for Availing Treatment

To ensure a smooth and hassle-free experience at the hospital, it is important to have all the necessary documents ready. Having these on hand will speed up the verification and pre-authorisation process, allowing the medical team to proceed with your treatment promptly.

The most critical document is your CMCHIS e-card. This card contains your unique identification number and is the primary proof of your membership in the scheme. Along with the card, you must carry a valid government-issued photo identification document to verify your identity. Accepted forms of ID typically include:

• Aadhaar Card
• Ration Card
• Voter ID Card
• Driving License

Understanding Scheme Coverage: What Is and Isn't Included

The CMCHIS provides coverage for a wide range of medical and surgical procedures. The scheme is designed to cover significant health events that require hospitalisation, including treatments for cardiovascular diseases, cancer, kidney ailments, orthopaedic surgeries, and neonatal care. The scheme specifies a list of over 1,000 procedures for which beneficiaries can receive cashless treatment.

However, it is important to understand that the scheme does not cover all medical expenses. Generally, outpatient consultations, diagnostic tests that do not lead to hospitalisation, and medicines prescribed on an outpatient basis are not covered. Similarly, treatments that are considered cosmetic in nature or certain high-end, experimental procedures may be excluded. Before undergoing any planned procedure, it is advisable to have the hospital confirm whether the specific treatment is covered under CMCHIS to avoid any unexpected costs.

What to Do if an Empanelled Hospital Refuses Service

While it is uncommon, you might encounter a situation where an empanelled hospital denies cashless treatment under CMCHIS. It is important to know that as per their agreement with the government, these hospitals are obligated to provide services for all covered procedures to eligible beneficiaries. If you face a refusal, do not panic. First, calmly ask the hospital administration for the specific reason for the denial in writing.

Immediately contact the CMCHIS authorities. You can call their 24x7 toll-free helpline to report the incident. Provide them with the name of the hospital, the person you spoke with, and the details of the situation. District coordinators are also appointed to resolve such grievances. Escalating the issue promptly often leads to a quick resolution, as the scheme administrators can intervene directly with the hospital management. Remember to keep a record of all your communications for future reference.

How to Verify a Hospital's Current Empanelment Status

The list of hospitals empanelled under CMCHIS is subject to change. New hospitals may be added, or existing ones may be removed from the network based on performance and other criteria. Therefore, before planning a visit, it is always best to verify the current empanelment status of a hospital.

The most reliable and up-to-date source of information is the official CMCHIS website: www.cmchistn.com. The portal has a dedicated section or a search feature that allows you to look up empanelled hospitals by district and city. By using this official resource, you can confirm that the hospital you intend to visit is still part of the network, ensuring that you will be able to avail the cashless facility. This simple check can prevent the inconvenience of being turned away or asked to pay for treatment at a facility that is no longer empanelled.

Frequently Asked Questions

Can I use my CMCHIS card at any hospital in Chennai?

No, you can only avail cashless treatment at hospitals that are specifically empanelled under the Chief Minister's Comprehensive Health Insurance Scheme. If you seek treatment at a non-empanelled hospital, you will have to bear the costs yourself.

What should I do in a medical emergency?

In a medical emergency, you should go to the nearest CMCHIS-empanelled hospital. The hospital will start the necessary treatment immediately while the pre-authorisation process is completed simultaneously to ensure you receive timely care.

How can I find the most current list of empanelled hospitals in Chennai?

The most reliable source is the official CMCHIS website (www.cmchistn.com). The list of hospitals can change, so it is always best to check the portal's hospital search feature for the latest information before a planned hospital visit.

Does the CMCHIS cover the cost of medicines and tests?

The scheme covers costs associated with hospitalisation, including medicines, diagnostics, and room charges during your stay. However, it generally does not cover outpatient consultations or medicines and tests prescribed on an outpatient basis.

Is there any cost for enrolling in the CMCHIS?

No, there is no direct enrollment cost for beneficiaries. Eligible families are identified by the state government based on specific socio-economic criteria, and enrollment is managed through government processes.

A hospital on the list is just marked as 'Chennai'. How do I find its exact address?

For hospitals where a specific locality is not mentioned, you can find the complete address and contact details by searching for the hospital's name online. Alternatively, the hospital locator tool on the official CMCHIS portal provides detailed location information for all empanelled facilities.

Related

• CMCHIS in Tamil Nadu: eligibility and how to enrol
• Government hospital OPD appointment guides in Tamil Nadu
• Mukhyamantri Swasthya Bima Yojana: which state scheme is it?

Medical Disclaimer

The information provided in this article is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.