The All India Institute of Medical Sciences (AIIMS)-Patna on Monday terminated the service contract of a Delhi-based firm after its personnel allegedly swindled ₹3 lakh from patients by tampering their hospitalisation bills, using software tools to edit and inflate them, said top officials.
The decision comes four days after HT flagged the matter to its executive director-cum-chief executive officer Dr Gopal Krushna Pal through an e-mail on January 11, seeking an official reaction.
On Monday, two days after his return from AIIMS-Gorakhpur, where he holds additional charge, Dr Pal terminated the service contract of the Delhi-based firm, which had given around 33 staff to man the 28 registration and billing counters at AIIMS-Patna. The three-year service contract of the firm was to end on March 21 this year.
Over 25 cases, each having a variation between ₹1,000 and ₹6,000 in the total amount of the actual bill reflecting in the hospital information system (HIS) and the fudged bill presented to patients at the time of their discharge, have so far been detected since January 2, when the matter first came to light at the AIIMS, said officials.
The lid over the unholy nexus of cash counter staff tampering with hospital in-patient bills, by first downloading them on their computer and then using software tools to edit and inflate the amount in the PDF copy of the consolidated bill, before presenting it to the patients or their attendants at the time of discharge, was blown off when a man, seeking reimbursement of hospitalisation charges of his mother through an insurance firm, submitted the bill to the AIIMS for verification. The officials then detected the discrepancy in amounts, as mentioned on the bill and the one in the hospital information system, said officials familiar with the matter.
Subsequently, a random scrutiny of hospitalisation bills of patients either discharged or having died in course of treatment since last July, revealed tampering of many bills, amounting to over ₹3 lakh.
An investigation by HT revealed a difference of ₹6,000 in the bill presented to Ravi Shankar Singh, having been charged ₹87,859.79 against an actual bill of ₹81,859.79. Md Gajanafar paid ₹5,000 in excess of the actual bill of ₹37,744.75; Nakhat Shaheen and Aditya Narayan paid an additional ₹4,000 each, with Shaheen having been charged ₹56,777.82 against an actual bill of ₹52,777.82, while Narayan paid ₹82,410.52 against an actual bill of ₹ 78,410.52.
Bhiran Sahni, whose actual hospitalisation bill was ₹1,05,779.96, Vikram Kumar ( ₹43,643.86), Nishna Kumari ( ₹13,316.17) and Kanchan Devi ( ₹6,309.75) paid ₹3,000 in excess of their actual bill.
Similarly, Manisha Singh ( ₹12,708.99), Nitish Kumar ( ₹28,293.32), Sheelal Singh ( ₹20,596.29), Kewla Devi ( ₹1,79,804.28) and Bimal Kumar ( ₹62,504) paid ₹2,000 in excess of their actual bill, while Joga Devi was charged ₹2,334 in excess of her actual bill of ₹1,51,183.
“We have suspended the cash counter clerks of outsourced firm, allegedly involved in the fraud, and also terminated the contract of the firm from today (January 15). We will take further action based on the findings of an internal committee, which is investigating the matter,” said Dr Pal.
Though the AIIMS was quick to blame the outsourced agency for the wrongdoing, its finance wing was caught napping for not reconciling accounts on a daily basis. The accounts team of AIIMS did not keep tabs of the daily remittance through its cash counters and the daily consolidated account summary in its hospital information system, leading to the fraud, said an official familiar with the matter.
“The issue of discrepancy in in-patient bills, as reflected in the hospital information system and the amount collected from patients, was detected by our Medical Records Department (MRD) on January 2. A fact-finding committee has been constituted and is investigating the matter. I took the decision to terminate the services of the firm as soon as I returned to Patna from AIIMS, Gorakhpur. on January 13,” said Dr Pal.
Efforts to reach the head of human resources at the firm in question proved futile as he did not respond to HT’s calls or text messages on his mobile phone. The landline telephone of the firm went unanswered on Monday evening.
