Dear Friends and Seniors,
Good evening! I am working in an Automobile Dealership in Vijayawada, Andhra Pradesh. Recently, one of our housekeeping staff went to the ESI Dispensary (Local) to get medicines after his visit to the ESI Hospital, which is the regional office itself for the state. The dispensary staff did not issue medicines to him, stating that the medicines were not available and it would take time to procure them. Having no choice, my staff purchased medicines from the market outside and consumed them.
Not only him, but one of my HR friends also shared the same experience with the dispensary.
Procedure to Complain About ESI Dispensary Issues
Do we have any procedure to complain regarding this to the local heads or higher authority? Please suggest or guide me through the process.
From India, Delhi
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1Good evening! I am working in an Automobile Dealership in Vijayawada, Andhra Pradesh. Recently, one of our housekeeping staff went to the ESI Dispensary (Local) to get medicines after his visit to the ESI Hospital, which is the regional office itself for the state. The dispensary staff did not issue medicines to him, stating that the medicines were not available and it would take time to procure them. Having no choice, my staff purchased medicines from the market outside and consumed them.
Not only him, but one of my HR friends also shared the same experience with the dispensary.
Procedure to Complain About ESI Dispensary Issues
Do we have any procedure to complain regarding this to the local heads or higher authority? Please suggest or guide me through the process.
From India, Delhi
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Reimbursement Process for ESI Prescribed Medicines
If the ESI dispensary is unable to provide the prescribed medicines from the ESIC doctor's prescription, they will make remarks on the requisition along with a seal. Subsequently, the employee purchases the medication and submits the bills along with an application to the AMO/ESIC for reimbursement.
Guidance for ESIC Doctors
Doctors from ESIC hospitals and dispensaries can seek assistance and guidance on the reimbursement procedure. It may take some time at the AMO office to reconcile the expenses with the respective dispensary. Once verified, the reimbursement is credited to the bank account linked to the IP.
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If the ESI dispensary is unable to provide the prescribed medicines from the ESIC doctor's prescription, they will make remarks on the requisition along with a seal. Subsequently, the employee purchases the medication and submits the bills along with an application to the AMO/ESIC for reimbursement.
Guidance for ESIC Doctors
Doctors from ESIC hospitals and dispensaries can seek assistance and guidance on the reimbursement procedure. It may take some time at the AMO office to reconcile the expenses with the respective dispensary. Once verified, the reimbursement is credited to the bank account linked to the IP.
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Thank you very much for your information. As you mentioned, when staff finds no medicines at the local dispensary, they simply advise people to buy them from the local market without noting the unavailability of medicines at the dispensary and suggest returning after a week or 10 days. Once the given time is over, the same response is given by the dispensary staff to purchase medicines externally.
If it is a situation where staff cannot afford medicines for a particular disease or condition, where should they go? Even though there is a Regional Office for Andhra Pradesh on its nearby campus, there are no proper escalations happening regarding this issue.
Is there a facility to address these issues with a redressal board or committee? Please advise.
From India, Delhi
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If it is a situation where staff cannot afford medicines for a particular disease or condition, where should they go? Even though there is a Regional Office for Andhra Pradesh on its nearby campus, there are no proper escalations happening regarding this issue.
Is there a facility to address these issues with a redressal board or committee? Please advise.
From India, Delhi
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Prescription and Medicine Availability in ESIC
The prescription is not made by the insured person (IP) but by the hospital, dispensary, or panel doctor of ESIC. Therefore, the IP has the right to receive the medicine as they have paid contributions towards medical treatment and other benefits.
In case of a shortage of stock, they may ask the member to revisit after a break. They cannot deny the tender. If they do, they should ask the IP to sign and stamp with the remark "not available" along with the date. Following that remark, the IP can purchase the medicine and get it reimbursed from the Assistant Medical Officer (AMO).
Alternatively, the IP can revisit the doctor and request a change in the medicine, which may be available through ESIC.
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The prescription is not made by the insured person (IP) but by the hospital, dispensary, or panel doctor of ESIC. Therefore, the IP has the right to receive the medicine as they have paid contributions towards medical treatment and other benefits.
In case of a shortage of stock, they may ask the member to revisit after a break. They cannot deny the tender. If they do, they should ask the IP to sign and stamp with the remark "not available" along with the date. Following that remark, the IP can purchase the medicine and get it reimbursed from the Assistant Medical Officer (AMO).
Alternatively, the IP can revisit the doctor and request a change in the medicine, which may be available through ESIC.
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Revised procedure for ESI claims.pdf
ESI.pptx