DIRECTQRA TE (MEDICAL) DELHIE.S.I. SCHEME: E.S.I. DISPENSARY-COMPLEX,

(NEAR WORKS DEPTT.: OPP. POLICE POST)TILAK VIHAR: NEW DELHI -110 018.

F.No.: DMU/t 6/5 trrie-Up/2008/Med-1I /6/ GCIRCULAR

Dated: (:9.06.10-~ '/Sub: Provision of medical facilities not available in ESI Hospitals in Delhi & NCH. region to

Insured Person, ESIC Employees! Pensioners and their dependents covered under ESIScheme. DelhilNew DelhiINoida through tie-up arrangement with CGHS approvedinstitutions.

In accordance with Hqrs. letter number V-24111/10/2004-Med.-1 dated 11.8.09 and in continuationof this office circular of even number dated 01.01.10, further arrangement has been J nade for a periodup to 31.12.2010 with the following Hospitals/Centres for Haemodialysis facilities as mentionedagainst their names below at their Centres on cashless basis in respect ofInsured Persons, ESIC serving& retired employees (Pensioners) and their dependents covered under ESI Scheme, Delhi/NewDelhilNoida :-

SI.No TelephoneNo.

Haemodialysis facilitil's for whichempanelled.

Address of theCentre whereHaemodiaysisfacilities areavailable.

Name & addressof the empanelledHospital/Institution.

11.11 III IV V

Same as columnno. 11.

430756002237852 to58Fax:22372851

Empanelled for all IlaemodialysisProcedures as mentioned in the list ofProcedures (Rate List) under Para 2below.

PushpanjaliMedical CentreHeart & TraumaHospital,(a unit ofM.M. Health CareLimited),A-15,Pushpanjali,Vikas MargExtension,DELHI 110 092.

12. Metro Hospital &Cancer Institute(A unit of MetroMedical ServicesLtd. ),21,CommunityCentre, PreetVihar,DELHI -110092.--:-::~-+-----~--+-----:--~-~-+-:--:-.,-----II-:-:--------"------1

13. Metro - do - 0 120- -do- ~,Multispeciaiity 2522959,

2442666Hospital, Fax: 0120-( A unit of Metro 2442555Institutes of \Medical SciencesPrivate Ltd. ),L-94, Sector-l l ,NOIDA - 20 1 30 I.

I--~-+~~-----------~-----~--~--~----~~--'~~~--~-14. Kailash -do- 0120- Empanelled for all Ilaemodialysis

Healthcare Ltd, 244 4444, Procedures as mentioned in the list ofKailash Hospital 2445566 Procedures (Rate List) under Para 2

Fax: 0120- below except for Australia Antigenand Heart 2533333 Positive Cases and 11.1.V. PositiveInstitute,H-33, casesSector-27"NOIDA - 20] 301

- do - 22460009,22019855,22019857,22520480,22526870Fax:22526671

- do -

'....•

Approved Rates for the different haemodialysis procedures are as under :-

SI.No. Name of Procedure Approved Rate (h)I. Haemodialysis for Australia Antigen/H.C.V. Negative case. 10002. Haemodialysis for Australia Antigen/H.C.V. Positive case. 15503. Haemodialysis ofH.I.V. Positive cases 1550.-4. ffeparin Free dialysis 10005. Femoral Canula Insertion 8506. Jugular/sub-clavian canula Insertion 22007. Making of A.V. Fistula 41608. A.V. Fistula re-do 35009. Exploration Vessels for making of A.V. Fistula 100010. Blood/Blood Product Transfusion No extra charge11. Viral Markers 50012. Perm Cath Insertion 1000013. CAPD Catheter Insertion (Open surgical technique) 500014. CAPD Catheter Insertion (Laproscopic technique) 8000--IS. CAPD Catheter re-positioning 600016. CAPD Catheter removal in O.T. 2500

W&/~ADDITIONAL DIREC~

Distribution :-

I. The Medical Commissioner, Medical Branch-I, ESI Corporation, Panchdeep Bhawan, CIGRoad, New Delhi- 110002. w.r.t. headquarters letter no. Hqrs. letter number V-24111/10/2004-Med.-I dated 11.8.09.

2-4. The Joint Director (Administration), ACP&A Branch/Estt.-IV/Estt.VI,Hqrs. Office.

5-9. The Medical Superintendent, ESI Hospital, Basaidarapur/Jhilmil/Rohini/Okhla and Director(Medical) Noida. Copy of text of the Agreement consisting terms & conditions of

rlment has been already sent vide this office circular of even number dated 24.12.09.

~ The Director (Systems), ESI Corporation, Panchdeep Bhawan, CIG Road, New Delhi-110002: with the request to upload the names of the Centres for empanelment ofHaemodialysis facilities on the ESI Website.

11-15. Joint Director Finance/Administration, Ncs. Br.1lI (M), Cash Branch(M),Estt. Branch- II(M)

16. P.S. to the Director General Hqrs. Office for information.

17. P.S to the Director (Medical) Delhi.

18-49.I.M.O. Incharge, E.S.1. Dispensary, _

a

In continuation of this office circular dated 30/91 08, 1/101 08, 7/10108, 20110108,1.1.2009,13.1.09,18.2.09, 19.3.09,20.10.09,30.10.09,12.04.2010,3.5.10, 26.4.10, 3.06.10,1'4.06.10,22.6.10 and in accordance with Hqrs. letter no. V-24/11/S/2007/Med.I Policy Tie-updated 25.3.2010, the Director (Medical) Delhi has further approved the empanelment of thefollowing hospital for the medical facilities as mentioned against its name below at CGHSapproved rates (except blood bank services) and for blood bank services at All MS rates w.e.f.21.06.10 to 20.06.2011 for the medical facilities as mentioned against the name of the hospitalbelow and are not available at large in ESI Hospitals, in r/o Insured Persons, ESICemployees/Pensioners and their dependents covered under ESl Scheme, Delhi/NewDelhi/Noida :- '

S.No. Name and Address ofInstitution

TelephoneNumber

Medical Facilities for whichEmpanelled

38. Pushpanjali CrosslayHospital ( a unit of"Crosslay RemediesLimited"), W-3, Sector-I,Vaishali, Ghaziabad, V.P.- 201 001.

./ ~:~-....,.. DIRECTORATE (MEDICAL) DELID/~.J"\t-, .,,' =.. ~.~~\ E.S.I.SCBtME: E.S.I.DISPENSARY COMPLEX,!~..,'7;) \ (NEARWORJ{S DEPTI'.; OPP. POLICE POST)lli/.' .... .' \ ~ \ TILAK VlHAR: NEW DELHI-110 018.,_.;,' "c . e:I':.· > . t~\~:~.:DMU/l615 Iffie-UpI2008IMed-Il ~

~/(->., . ~/ CIRCULAR.:. ". .:.,::::~.)..~

Sub: Provision of medical facilities not available in ESI Hospitals in Delhi &NCR region to Insured Person, ESIC Employees/ Pensioners and theirdependents covered under ESI Scheme, DelhilNew DelhiINoida throughtie-up arrangement with reputed private institutions.

0120-4188000

I. SUPER SPEICALITYTREATMENTIPROCEDURES:I. Special Dental Procedures a) Oral

Maxillary Surgery & MandibularSurgery b) Periodontal Surgery

2. Retinal Surgery including LaserTherapy, Vitreoretinal Surgery.

3. Laproscopic Surgery in the field ofGynaecology & Obstrics.4. Paediatric Surgery5. Urology & Endoscopic UrologicalProcedures A) URS B) InternalopticalUrethertomy6. Emergency Bronchoscopy &Endoscopy7. Plastic Surgery in relation to Gynae.8. Advance infertility Management9. Plastic Surgery.11.Super speicality /specialInvestigation:

I. Echocardiography: StressECHO/Bedside ECHO

2, Stress Echocardiography3.. Color Doppler: Heart/Peripheral

Vessels4. T.E.E. (Trans Esophageal

Echocardiography)5. T.M.T.6. Holter7. Electro Physiological Studies for

Arrythmia8. Bronchoscopy: Adult (FOB)/

Paediatric/Emergency (Diagnostic& Therapic)

9. Complete P.F.T.10. CT Scan all body parts I11. CECT Scan all body parts

Sub: Provision of medical facilities not available in ESI Hospitals in Delhi &NCR region to Insured Person, ESIC Employees/ Pensioners and theirdependents covered under ESI Scheme, DelhilNew DelhiINoida throughtie-up arrangement with reputed private institutions.

In continuation of this office circular dated 30/9/ 08, 1/10/ 08, 7/l 0/08, 20/10/08,1.1.2009,13.1.09,18.2.09, 19.3.09,20.10.09,30.10.09, 12.04.2010,3.5.10,26.4.10,3.06.10,1'4.06.10,22.6.10 and in accordance with Hqrs. letter no. V-24/11/5/2007/Med.l Policy Tie-updated 25.3.2010, the Director (Medical) Delhi has further approved the empanelment of thefollowing hospital for the medical facilities as mentioned against its name below at CGHSapproved rates (except blood bank services) and for blood bank services at AIIMS rates w.e.f.21.06.10 to 20.06.2011 for the medical facilities as mentioned against the name of the hospitalbelow and are not available at large in ESI Hospitals, in r/o Insured Persons, ESICemployees/Pensioners and their dependents covered under ESI Scheme, Delhi/NewDelhi/Noida :-

S.No. Name and Address ofInstitution

TelephoneNumber

Medical FacilitiesEmpanelled

for which I38. Pushpanjali Crosslay

Hospital ( a unit of"Crosslay RemediesLimited"), W-3, Sector-I,Vaishali, Ghaziabad, U.P.- 201 001.

0120-4188000

I. SUPER SPEICALITYTREATMENTIPROCEDURES:1. Special Dental Procedures a) Oral

Maxillary Surgery & MandibularSurgery b) Periodontal Surgery

2. Retinal Surgery including LaserTherapy, Vitreoretinal Surgery.

3. Laproscopic Surgery in the field ofGynaecology & Obstrics.4. Paediatric Surgery5. Urology & Endoscopic Urological

Procedures A) URS B) InternalopticalUrethertomy6. Emergency Bronchoscopy &Endoscopy7. Plastic Surgery in relation to Gynae.8. Advance infertility Management9. Plastic Surgery.11.Super speicality /specialInvestigation:

1. Echocardiography: StressECHO/Bedside ECHO

2. Stress Echocardiography3.. Color Doppler: Heart/Peripheral

Vessels4. T.E.E. (Trans Esophageal

Echocardiography)5. T.M.T.6. Holter7. Electro Physiological Studies for

Arrythmia8. Bronchoscopy: Adult (FOB)/

Paediatric/Emergency (Diagnostic& Therapic)

9. Complete P.F.T.10. CT Scan all body parts11. CECT Scan all body parts12. M.R.t. all body parts13. CE MRI all body parts14. EEG: Adult/Paediatric15. NCV: Upper Limb/Lower Limb16. OPG with report/standard occruals

view of upper and lower jaw17. CT guided biopsy18. MR Angiography19. CT Urography P.T.O.

220. MRI Urography21. MR Spectroscopy22. Dexa Scan for Bon .23. Mammography24. Uroflornetry25. All ultrasound in e26. All level n ultrasou27. T.V.S.28. Color Doppler with29. Ultrasound for eye

posterior segment30. Retinal Imaging31. Retinal Flourescent32. Retinal Angiograp33. Tympanometry34. Colposcopy

BLOOD BANK1. Whole Blood2. Blood Components

e :Jensiometry

mcrgencylids

',relocitometry;~Iuding

Angiographyh.

The draft agreement is the same as already circulated vide this office aft.esaid circulars.The content of this circular may be brought to the notice of all concerned and may also bedisplayed on the Notice Board.

Distribution :-

w(ppfW'ADDITIONAL DI~OR

I. The Medical Commissioner, Medical Branch-l , ESICorporat:. 11, PanchdeepBhawan, CIG Road, New Delhi- 110002. with reference toheadqua. 'ers letter no.V-24/11/10/2004-Med-l, Dated 23.7.2008 & V-24/11/5/2007/Med.I Policy Tie-up dated25.3.2010.

2-4. The . t Director (Administration), ACP&A Branch/Estt.-IV/Estt.VI.qrs. Office.

The Jt. Director (Systems), ESIC Hqrs. Office with the request to add the abovehospital in the list of empanelled hospitals under E.S.I. Scheme, Delhi/New Delhias existing on ESIC web-site.

6-10. The Medical Superintendent, BSI Hospital, Basaidarapur/Jhilmil/Rc : ini/Okhla andDirector (Medical) Noida.

11-15. Joint Director Finance/Administration, A/cs. Br.III (M), Cash Brancht 1),Estt. Branch- II(M)

16. P.S. to the Director General Hqrs. Office for information.17. P.S to the Director (Medical) Delhi.18-49. I.M.O. Incharge, E.S.1. Dispensary, _