Step 1: Who should use the referral route
Use the normal referral route when an ECHS doctor decides that consultation, investigation or treatment is required beyond what the polyclinic can provide. A medical emergency is different: do not delay life- or limb-saving care merely to obtain a routine referral.
Step 2: What to keep ready
Carry the beneficiary’s valid ECHS card or accepted entitlement document, available medical records, previous prescriptions/reports and details of the problem. If this is a follow-up, also keep the earlier referral, hospital papers and advice.
Step 3: Start at the ECHS polyclinic
Report to the ECHS polyclinic and consult the Medical Officer/specialist as applicable. Explain the condition and show previous reports. The treating ECHS doctor decides whether referral for specialist consultation, investigation or treatment is medically required.
Step 4: Check the referral before you leave
Read the referral/authorisation carefully. Confirm the beneficiary details, speciality or investigation/treatment, and the hospital/facility or other conditions shown on it. If anything is unclear or incorrect, get it clarified at the polyclinic before travelling.
Step 5: Choose and verify the hospital
Use the current “Empanelled Hospital Details” link on the official ECHS website or ask the polyclinic. Confirm that the hospital is currently empanelled for the required speciality/service—not merely that the hospital name appears on an old list.
Step 6: Report to the hospital with the referral
At the empanelled hospital, show the ECHS card/accepted entitlement document and referral/authorisation. The hospital should process an authorised referred case under the ECHS cashless system within its empanelled scope.
Step 7: If further approval, extension or revisit is needed
Do not assume one referral covers every later procedure or unlimited visits. Follow the instructions recorded by the hospital/ECHS authority. Some categories have specific validity rules; the ECHS FAQ, for example, states six-month validity for consultation, investigation and treatment in cardiac, oncology and nephrology cases. Newer referral instructions should take priority where applicable.
Step 8: If the hospital asks for cash
For an authorised cashless case, first ask the hospital ECHS/help desk to re-check the referral and entitlement. If the issue is not resolved, contact the OIC of the nearest/parent polyclinic and the Director Regional Centre. ECHS specifically provides a complaint/inquiry route for problems involving empanelled hospitals.
Step 9: How long does referral processing take?
ECHS does not publish one guaranteed disposal time that applies to every referral, approval and speciality. Do not rely on an invented “7-day” or “15-day” promise. If a medically required referral remains pending, follow up with the polyclinic and Regional Centre with the referral/application details.
Step 10: Common mistakes to avoid
Do not travel on an old hospital list; do not assume every speciality at an empanelled hospital is covered; do not pay a large amount merely because the desk says “ECHS approval pending” without contacting ECHS; and do not treat emergency and planned-treatment rules as the same.
Step 11: Whom to contact
Start with the OIC/medical team of the ECHS polyclinic handling the referral. Escalate unresolved hospital/referral issues to the Director Regional Centre. The official ECHS helpline shown on its website is 1800-114-115.
Frequently asked questions
Can I directly choose any empanelled hospital for planned treatment?
Not automatically. Planned treatment normally follows the ECHS referral/authorisation route and the required speciality must be covered.
Is every referral valid for six months?
No. The six-month statement in the official FAQ applies to specified cardiac, oncology and nephrology cases. Check the current rule for your treatment category.
What if the hospital demands cash?
Ask its ECHS desk to re-check the authorised case, then contact the polyclinic OIC and Director Regional Centre if unresolved.
Is there a fixed ECHS referral processing time?
ECHS does not publish one universal guaranteed time for every referral type.