The Aarogya Mitra is the primary contact for the beneficiaries at every Empanelled Health Care Providers

The Aarogya Mitra shall be responsible for focusing on three broad areas:

  1. Operating the "Beneficiary Identification System" to identify and verify the beneficiaries entitled under AB-PMJAY.
  2. Undertaking "Transaction Management" such as submitting requests for Pre-Authorization and Claims.
  3. Guiding the Beneficiary about the overall benefits under AB-PMJAY and providing information about receiving prompt treatment at Empanelled Health Care Providers.

Beneficiary Identification

  1. Collects the Aadhaar Card, Family ID Card or any other Government ID Card from the beneficiary.
  2. Searches name, verifies names based on Govt ID card, authenticate beneficiary, take a photo and establishes beneficiary relation with the family
  3. Aarogya Mitra receives family and individual match scores; record is saved as ‘Silver Record’ and a provisional card generated
  4. Records submitted to verifying authority; once approved, record is saved as ‘Golden Record’
  5. Aarogya Mitra will then print the AB-PMJAY e-Card as “Golden Record” and give it to the beneficiary

At Empanelled Hospital for Care Seeking

  1. Provide all the necessary assistance and details about the scheme; help locate facilities and guide a patient
  2. Collect, scan and upload all the necessary documents for pre-authorization.
  3. Liaison with the EHCP for timely admission and availability of bed to patient
  4. Liaison and coordinate with the Medical officer for collecting, scanning and uploading all the necessary documents required for submitting claim request.
  5. Verify discharge summary and follow-up details to the discharged beneficiaries
  6. Bring all grievances to the notice of Grievance Cell.
  7. Track and report refund of any investigation amount collected in contravention to the Guidelines
  8. Report any irregularities or inadequacy noticed

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