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Billing & finance

CGHS (Central Government Health Scheme)

In short

A government scheme providing healthcare to central-government employees and pensioners; hospitals may be empanelled at CGHS rates.

Category
Billing & finance

The Central Government Health Scheme (CGHS) provides healthcare to serving and retired central-government employees, pensioners and their dependants across many Indian cities. Private hospitals and diagnostic centres can apply to be empanelled to treat CGHS beneficiaries at notified CGHS package rates, which are typically settled with the government rather than the patient.

Why it matters in a hospital

CGHS empanelment can be a meaningful, relatively stable patient channel for hospitals in cities with a large central-government workforce, but empanelment comes with an obligation to bill strictly at the notified rate, maintain the specific documentation reimbursement requires, and manage settlement timelines with a government payer rather than an individual patient. Because CGHS rates are typically lower than a hospital's general tariff, a facility taking on CGHS patients is usually doing so for volume and community reach rather than margin on that specific patient category — a trade-off worth being deliberate about when deciding how much CGHS volume to take on.

How Trisvio handles it

Trisvio does not currently offer scheme-specific empanelment tooling or a built-in CGHS rate card; a hospital serving CGHS beneficiaries would need to configure and apply those notified rates as a standard tariff within its existing billing setup, and manage documentation for reimbursement separately. The tariff engine that handles this for CGHS is the same one used for any other payer category, so adding a CGHS rate card needs no separate software, and CGHS bills flow through the same daily-collection reconciliation as any other patient category.

In Trisvio

See how Trisvio supports this in practice.

Related

Related terms