UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which...

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UHMS–Unified Health Management System WELCOME TO UNIFIED HEALTH MANAGEMENT SYSTEM This user guide provides a quick overview of how to get started and use UHMS system. Overview UHMS (Unified Health Management System) A single platform catering to administration of Medical benefits including Referral to outside hospital Inhouse OPD management (wherever such a facility exists) Inhouse Hospital services (wherever such a facility exists) Pharmacy Management services (wherever such a facility exists) RECHS – registration & revalidation Billing processing & creation

Transcript of UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which...

Page 1: UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which the employees will be visible to this Unit Administrators, so that he can manage

UHMS–Unified Health Management System  

WELCOME TO UNIFIED HEALTH MANAGEMENT SYSTEM 

This user guide provides a quick overview of how to get started and use UHMS system. 

Overview 

UHMS (Unified Health Management System) 

A single platform catering to administration of Medical benefits including  

‐ Referral to outside hospital 

‐ In‐house OPD management     (wherever such a facility exists) 

‐ In‐house Hospital services        (wherever such a facility exists) 

‐ Pharmacy Management services  (wherever such a facility exists) 

‐ RECHS – registration & revalidation 

‐ Billing  ‐ processing & creation   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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URL address: 

1) http://ecare.bhel.in/uhms  

2) or through single sign on link from top left corner in   

http://intranet.bhel.in    SINGLE SIGN‐IN 

 

 

 

 

 

 

 

 

Insert URL address 

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Key in your staff no. & password 

 

Select your Unit from drop down  

 

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Initially Staff no shall be the default password for system users, with a provision under Home Tab to change 

password.  

 

 

 

 

 

Various tabs of the UHMS module are provided 

 

Provision to 

change 

password.  

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TAB ‐REFERRAL 

Under  this module, provision  to  refer  an  employee  (serving/retired)  to outside BHEL hospital  – 

hospital on panel of BHEL, is being provided. The module includes  

‐ generate referral (Employee) for hospitalisation, 

‐ generate referral (RECHS) for hospitalisation, 

‐ generate referral for Day care procedures,  

‐ generate referral (CISF),  

‐ Approve Referral, 

‐ Special Referral, 

‐ View Referral  

 

 

Exception: 

Medical benefits to CISF employee as per MOU is also being catered under this module.  

 

 

 

 

 

 

 

Referral module and its provisions 

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PROCESS FLOW 

 

 

 

 

GENERATE REFERRAL 

 

 

 

 

 

Key in the staff no for whom the 

referral is to be generated and click 

Search 

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For referral 

From  drop  down  list,  select  dependents  data  for  whom  the  referral  is  to  be  issued,  the  doctor  who  is 

generating  the referral, hospital  from  the registered Unit/region hospital  list, broad ailment  list and referral 

type.  

Default mapping of ward type & treatment type is made based on the extant Policy provisions/department.   

 

From drop down 

select all the 

relevant details 

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Referral no. for the employee has been 

generated which has Unit code/year/nature 

of employee/patient code/sl. no  

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VIEW REFERRRAL  

 

All  the  referrals generated  for all employees can be viewed by clicking on  the  ‘view  referral’  tab. Particular 

referral no. can be clicked for viewing the details. 

 

 

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This is the view of the referral after it is generated but not yet approved. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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APPROVE REFERRAL 

 

 

 

Click on the ‘approve referral’ tab in order to approve or reject a referral generated. Only after approval, the 

patient can visit the hospital referred to. 

 

 

 

 

 

 

 

 

 

 

 

 

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APPROVE/REJECT REFERRAL 

 

 

 

 

 

 

 

 

 

 

 

 

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VIEW REFERRAL 

 

 View of the referral after it has been approved. Option of print is available and also approval date is captured. 

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Final printout of the referral 

 

 

 

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SPECIAL APPROVAL:  

For exceptional cases of employees of other Units.  

Special approval  is done  for a referral generated  for an employee who belongs  to another Unit.  In 

such cases, such an employee belonging to other Unit can only be referred to hospital with which the 

unit providing special approval is having a contract with.  

 

First the referral is generated for the employee as in the normal case explained above while referral 

generation. Employee no. of the patient (employee) is keyed in as shown below. 

 

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SPECIAL APPROVAL: 

 Then special approval is provided to the employee as he / she does not belong to the Unit providing 

this approval as medical facilities are to be availed in a Unit other that the parent Unit of employee. 

 

 

 

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 Key in the staff no. of the employee and search 

 Approvals pending for this employee will appear 

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 An approval may be rejected or approved after opening. After approval an screen as below appears 

where print option is available. 

 

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Final printout of the referral 

 

 

 

Page 25: UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which the employees will be visible to this Unit Administrators, so that he can manage

RECHS Module 

 

 

 

 

 

 

 

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Page 27: UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which the employees will be visible to this Unit Administrators, so that he can manage

TAB ‐ ADMINSITRATION 

Under  this  module,  User  registrations  of  BHEL  serving  employees  /  retired  employees  /  CISF 

officials etc. and hospital registration along with upload of their Schedule of Charges are provided. 

The module includes  

‐ Hospital Registration 

‐ Unit Hospital Contract 

 

‐ User Registration (nomenclature will be replaced by ‘Unit Admin Registration’) 

‐ Unit User Registration (nomenclature will be replaced by ‘Unit Subadmin Registration’) 

‐ User Updation (nomenclature will be replaced by ‘Unit Admin Updation’) 

‐ Unit User Updation (nomenclature will be replaced by ‘Unit Subadmin Updation’) ‐ * Note:  Please  read  the  above  names which  have  to  be  changed  as  their  new  names  only wherever  they  appear  in  this 

document, as they will be soon changed in the UHMS. 

 

‐ Upload  Dependents  Photo  (nomenclature  will  be  replaced  by  ‘Upload  Emp.  Dependents 

Photo’) 

‐ CISF/ Govt. official Registration 

‐ CISF Dependents/ Govt. official Registration 

‐ CISF / Govt. official Dependents Photo 

‐ Upload Hospital SOC  

 

 

 

Admin module and its provisions 

Page 28: UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which the employees will be visible to this Unit Administrators, so that he can manage

PROCESS FLOW 

UNIT ADMIN REGISTRATION: 

 

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The  Unit  nominated  key  administrators  to  be  searched  by  their  Employee  ID  so  that  they  can  be  given 

permissions to further delegate permissions to define scope of work in his own Unit. 

NOTE: A single User may be made Administrator for more than one Unit. The provision is there. 

 

Key in the staff no of the Unit 

Administrator to be registered Unit 

wise by Corp. HR Policy

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BHEL Unit  for which  the  employees will be  visible  to  this Unit Administrators,  so  that he  can manage  the 

UHMS system  internally  for that Unit by giving  further permissions to the Medical Department/ HR etc. will 

have to be chosen from drop down menu as shown. 

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Unit Administrators in each Unit will be given permissions e.g. to generate/ approve referrals, delegate further 

powers to other employees of their particular Unit etc., by selecting multiple options (using drag / control / 

shift  to  select  and  deselect  options)  from  the  ROLE  which  defines  his  scope  of  work.  Central  UHMS 

administrator  (i.e. Corporate HR Policy department) will select  the Unit and Scope  for giving permissions  to 

Unit Administrator. Finally the data needs to be saved by clicking on ‘save’ tab. 

UNIT ADMIN UPDATION: 

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The details associated with the Unit Administrator can be modified using the ‘Unit Admin Update’ tab. 

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Staff no. and the Unit with which the Unit Administrator is associated need to be keyed in in order to update 

the details as entered above w.r.t. permissions etc. 

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Scope of permissions can be changed and then click ‘Update’. 

 

UNIT SUBADMIN REGISTRATION: 

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Page 36: UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which the employees will be visible to this Unit Administrators, so that he can manage

 

 

The Unit Administrator made above for each Unit can further assign permissions to define scope of work of 

multiple Users  in his/her own Unit  (for which he has been given permission). Unit Administrator can further 

delegate his powers  in his Unit. E.g.  limited permissions may be assigned  to Medical department  / HR etc. 

further by the Unit specific ‐ Unit Administrator. These employees will be made the Unit Subadmins. 

Key in the staff no of the Unit 

Subadmin. to be registered within a 

Unit by Unit Administrator 

Page 37: UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which the employees will be visible to this Unit Administrators, so that he can manage

 

In the same manner as Unit Admin. registration and updation is being done, Unit Subadmin Registration and 

updation is also following exactly the same procedure. The difference is that while choosing the Unit from the 

drop down menu, only the Units which are in scope of Unit Administrator are visible. 

UNIT SUBADMIN UPDATION: 

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CISF REGISTRATION: 

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CISF personnel may be registered from front end by entering their service no., name etc. 

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CISF DEPENDENTS REGISTRATION: 

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Page 46: UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which the employees will be visible to this Unit Administrators, so that he can manage

 

Service no. of the CISF personnel to be keyed in. 

 

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Details of CISF dependents can be added. 

CISF DEPENDENTS PHOTO 

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Provision  to  upload  CISF  dependents  photograph  –  available  by  clicking  on  CISF Dependents  Photo  tab  as 

shown above or the same can also be done by clicking on ‘Next to upload Photographs’ button, which appears 

on the screen where CISF dependents data is entered. 

Page 49: UHMS–Unified Health Management Systemsson.bhel.in/uhms/Referral_Module.pdf · BHEL Unit for which the employees will be visible to this Unit Administrators, so that he can manage

 

 

HOSPITAL REGISTRATION: 

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Make all the relevant entries while registering a new hospital which is on panel / in‐house for a particular BHEL 

Unit. 

UNIT HOSPITAL CONTRACT: 

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After registering the hospital, enter the contract  terms and conditions / scope / start and end dates etc. by 

going to the ‘Unit Hospital Contract’ tab.  

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Search for the registered hospital and chose from the drop down menu that appears as shown above. 

 

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To make a new / fresh contract  in the case of new hospital been registered, the data will be filled and  ‘save 

new contract’ button will be pressed. 

Few more  functionalities  like,  extension of  contract,  termination before  planned  contract period  etc.  are 

possible in case of contracts already entered. To use these functionalities, illustration is as follows: 

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Search for the registered hospitals and chose from the drop down menu that appears as shown above. 

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Enter all relevant field of the hospital contract – ward entitlements, start / end dates, contact person, scope of 

the contract etc. After this there are four tabs available at the end of this page: 

1. Save new contract – When a new / fresh contract is being made, this tab will be used. E.g. in the case 

above  where  new  hospital  has  been  registered  and  it’s  fresh  contract  is  being  added,  or  earlier 

contract has been de‐functionalized etc. 

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2. Extend  contract  –  If  only  the  end  date  of  the  contract  has  been  extended,  scope  etc.  remaining 

constant, then this tab will be used. 

 

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3. Terminate  contract‐ A  contract may be  terminated on or before  the planned end date mentioned.  

While terminating a contract prior to its expiry, the field in the ‘end date’ has to be filled with the date 

on which it has actually been closed (before planned contract validity ends). This date to be filled may 

be today’s date, when contract is being terminated online, or some date prior to that if it has already 

been closed on paper and entry is being made now. 

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Change  the  end  date  to  today’s  date  or  earlier  date  than  today’s  date  and  then  press  ‘terminate 

contract’ button. 

 

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4. Defunct contract – If the contract has been wrongly entered (and locked) and is not fit to be used for 

any  reference  generations,  then  defunct  tab  needs  to  be  used.  The  contract will  have  to  be  De‐

functionalized all together and a new contract will be made. 

LOCKING THE CONTRACT: 

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The contract must be locked after making any changes, only then the changes will be reflected outside to all 

users. Till the time it’s sure that all relevant details have been accurately put, contract should not be locked, as 

it may reflect wrong data and generate wrong references based on those details. In order to save the contract 

without locking, ‘Cancel’ button is to be pressed. 

UPLOAD HOSPITAL SOC: 

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Hospital’s SOC / Schedule of charges can be uploaded for billing purpose. 

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Chose the hospital and contract from drop down menu. 

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Upload the file in the given format. 

Various  tabs  are  being  provided  under  UHMS  system  viz.,  HOME,  REFERRAL,  OPD,  IPD,  PHARMACY  & 

DISPENSING, ADMIN, BILLING, REPORTS, LOGOUT provided in the system having various functionalities under 

each. 

Activity Responsibility Matrix: 

UHMS TAB  FUNCTIONALITY  PROVISIONS  NAME  OF  THE PERSON  RESPONSIBLE  (Unit to assign) 

HOME  Change password  

Scope: 1. Default Login password will be provided to Unit Admin.    / Role  assigned by Unit Admin. (Unit  Subadmin.)  User  name  and  password will be the same as Staff No. initially. 3. Provision  to change  the password  is  there. Users are required to change it after first time login. Who  will  do:  Corporate  Admin.  for  Unit Admin. / Unit Admin. for Unit Subadmin.  

 

REFERRAL  Generate Referral (Employee)  

Scope: Generates  referral  for serving employees and their dependents Who will  do: Unit Admin.  / Role  assigned by 

 

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   Generate Referral (RECHS)     Generate Referral (Daycare)       Generate Referral (CISF)      Approve Referral       Special Approval           View Referral       View  Employee Referral 

Unit Admin. (Unit Subadmin.)  Scope: Generates  referral  for  a  retired  employee/ beneficiaries Who will do: Unit Admin.   / Role assigned by Unit Admin. (Unit Subadmin.)  Scope: Generates  referrals  for  treatments  /  sittings which may  require 2‐3 hrs. of hospitalization (Day care procedures), where room rent is not chargeable. Who will do: Unit Admin.   / Role assigned by Unit Admin. (Unit Subadmin.)   Scope: Generates  referral  for  registered  CISF personnel  and  their  dependents  (see  Admin. Module) Who will do: Unit Admin.   / Role assigned by Unit Admin. (Unit Subadmin.)  Scope: Referral  approvals  by  senior  medical practitioners  /  HR  or  any  other  authorized agency  identified  by  the  Unit  for  approving referral after referral generation. Who will do: Unit Admin.   / Role assigned by Unit Admin. (Unit Subadmin.)  Scope: 1.  Generate  /  approve  referral  caters  to beneficiaries in their parent Unit.  2.  For  beneficiary  who  is  not  from  the  Unit where medical benefit is being availed, has to be  provided  medical  facility,  the  provision under  special  approval  may  be  utilized  for generating referral. Who will do: Unit Admin.   / Role assigned by Unit Admin. (Unit Subadmin.)  Scope: All  referrals  generated  for  all  employees  can be viewed here Who will do: Unit Admin.   / Role assigned by Unit Admin. (Unit Subadmin.)  Scope: All  referrals  generated  for  a  particular employee can be viewed.  Who will do: Unit Admin.   / Role assigned by Unit Admin. (Unit Subadmin.) 

ADMINSTRATION 

Hospital Registration 

Scope: 1.  In  house  BHEL  hospitals  to  be  registered 

 

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         Unit  Hospital Contract           Unit  Admin. Registration       Unit  Admin. Updation     Unit  Subadmin Registration             Unit  Subadmin Updation     Upload 

here. 2. All  active hospitals on panel of Unit  to be registered utilizing this facility. Who will do: Corporate Administrator List of Unit  Panel Hospitals  (see  format1):  to be  shared  with  Corp.  Admin.  (Most  of  the Hospitals are already listed. Units to check and revert for addition / deletion).  Scope: 1.    All  active  Unit  Hospital  Contracts  w.r.t. validity,  scope  of  empanelment,  room  rent etc.  to be maintained  2.  Contracts  to  be  fed  online  /  extended  / terminated  or  de‐functionalized.  These contracts  will  be  used  while  referral generation  to check  the scope/validity etc. of the contracts.  Who will  do: Unit Admin.  / Role  assigned by Unit Admin. (Unit Subadmin.)  Scope: The  Unit  administrators  to  be  given permissions to further delegate permissions to define scope of work in his own Unit. Who  will  do  (see  format2):  Central  UHMS administrator  (i.e.  Corporate  HR  Policy department)  Scope: Any change in Unit Administrator or his scope of work may be updated here. Who will do: Central UHMS administrator (i.e. Corporate HR Policy department)  Scope: 1. The  Unit  Administrator  in  each  Unit  can 

further  assign  permissions  based  on  the administrative practices in each Unit based on  scope  of  work  under  each  module. (Column at the right to be filled by Unit) 

2. Unit Administrator can further delegate his powers in his Unit. E.g. limited permissions may be assigned to Medical department / HR  etc.  further  by  the  Unit  specific  Unit Administrator.  

Who will do (see format3): Unit Administrator /  Role  assigned  by  Unit  Admin.  (Unit Subadmin.)  Scope: Any change  in User User or his scope of work may be updated here. Who  will  do:  Unit  Administrator  /  Role assigned by Unit Admin. (Unit Subadmin.)  

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Dependents Photo       CISF Registration        CISF Dependents  Registration    CISF Dependents Photo        Upload  Hospital SOC 

Scope: Provision  to  upload  photograph  of  the employee dependents as the data is not there in SAP. (see format3 – will be provided later) Who will do: Unit Admin.   / Role assigned by Unit Admin. (Unit Subadmin.) (first  time  Corporate  Admin. Will  do  to  facilitate  Unit with Bulk Upload) 

 Scope: Details of CISF personnel (wherever applicable with  respect  to Name,  Service No.  etc.)  (see format4). Who will do: Unit Admin.   / Role assigned by Unit Admin. (Unit Subadmin.) (first  time  Corporate  Admin. Will  do  to  facilitate  Unit with Bulk Upload) 

 Scope: Details of CISF dependents (see format4) Who will  do: Unit Admin.  / Role  assigned by Unit Admin. (Unit Subadmin.) (first  time  Corporate  Admin. Will  do  to  facilitate  Unit with Bulk Upload) 

 Scope: Provision  to  upload  photograph  of  CISF dependents  (see  format5  –  will  be  provided later) Who will  do: Unit Admin.  / Role  assigned by Unit Admin. (Unit Subadmin.) (first  time  Corporate  Admin. Will  do  to  facilitate  Unit with Bulk Upload) 

  Scope: 1.  Unit  panel  hospital  Schedule  of  Charges (SOC)  to be made available  in  the  system  for Billing Module.  2. all active panel hospital SOC  to be sourced and uploaded in the system (see format6) Who will  do: Unit Admin.  / Role  assigned by Unit Admin. (Unit Subadmin.) 

 

Note: The data  regarding all serving and  retired employees  is being  taken  from SAP. The same needs  to be 

updated and maintained in SAP system directly by Units. 

Retired employee’s registration as well as revalidation data need to be updated by Units in the formats sent to 

them directly in co‐ordination with SAP. 

CISF data  is being captured  in UHMS system  in the formats sent to Units.  IT may be entered from front end 

directly by Units.