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eCircular

Department: P&HRD
Sl.No.: 1193/2017 - 18
Circular No.: CDO/P&HRD-IR/83/2017 - 18
Date: Mon 8 Jan 2018

To
All Branches & Offices of
State Bank of India.

STAFF: MISCELLANEOUS
BANK’S MEDICAL REIMBURSEMENT SCHEME
WAIVER OF SCRUTINY OF MEDICAL BILLS UPTO Rs 2,000/-

Medical Benefits are extended to employees / officers and their dependent family members
under Bank’s Medical Reimbursement Scheme. The facilities are made available through tie-
up arrangements with diagnostic centres and hospitals as well as non-empanelled hospitals
along with domiciliary treatment. The expenses incurred on medical treatment are reimbursed
based on scrutiny of medical bills.

2. As per the extant instructions, Bank Medical officer/ Contract Doctors examine the bills
and put their explicit comments on the appropriateness of treatment and reasonableness of
expenditure claimed by the employees. The medical officer also indicates charges which are
not reimbursable. Once the bills are scrutinised by the Bank Medical Officer / Contract
Doctors, the sanctioning authority checks whether the expenses claimed in the bills are in line
with the schedule of reasonable charges, treatment has been taken in a class of bed as per
the entitlement, bills are submitted in original etc. The medical bills are sanctioned based on
observations of the Bank Medical Officers / Contract Doctors.

3. It has been observed that our Bank Medical Officers / Contract Doctors have to devote
a lot of time in scrutinising medical bills. At present, all the bills, irrespective of the amount,
are scrutinised by the medical officer.

4. The Competent Authority has since decided that the medical bills up to Rs. 2000/- may
be paid by the sanctioning authority without any scrutiny by the Bank Medical Officer /
Contract Doctor. In case of any doubt on admissibility of expenses incurred, clarification may
be sought from them, strictly on a need basis. Further, at least 1% of the sanctioned medical
bills up to Rs. 2000/- at each branch / office post-payment shall be subjected to scrutiny by
the Bank Medical Officer / Contract Doctor on random basis. The ‘Standard Operating
Procedure’ (SOP) for scrutiny of 1% of medical bills post-payment shall be as under:

i) All medical bills up to Rs. 2000/- shall be sanctioned without any scrutiny
by the Bank Medical Officer/Contact Doctor.
ii) In case of any doubt on admissibility of expenses incurred by the
employee, clarification may be sought from the Bank Medical
Officer/Contract Doctor, strictly on a need basis.
iii) At least 1% of the sanctioned medical bills up to Rs. 2000/- at each
branch/office shall be scrutinized by the Bank Medical Officer/Contract
Doctor at periodic intervals, depending upon the volume of bills. The
periodicity should not extend beyond once in a quarter.
iv) The bills for scrutiny shall be selected on a random basis.
v) The selected bills shall be forwarded by branches/offices to Bank Medical
Officer / Contract Doctor for scrutiny.

5. The existing instructions regarding the scrutiny of medical bills with upper ceiling of Rs.
10,000/- by Contract Doctors shall continue. The Permanent Part Time Medical Officer shall
continue to scrutiny bills without any ceiling.

6. The revised guidelines shall come into effect from 06/01/2018.

7. Please bring it to the notice of all concerned and arrange accordingly.

(Prashant Kumar)
Dy. Managing Director (HR) &
Corporate Development Officer