PM-JAY Grievance Redressal: How to Complain If a Hospital Denies Treatment
Quick answer: If an empanelled hospital denies you cashless treatment or asks for illegal payment under PM-JAY, you can file a complaint through the CGRMS portal (cgrms.pmjay.gov.in) or by calling the 14555 helpline. Keep your Ayushman Card number, hospital name, and any documentation — like a rejection note or payment receipt — ready before you file.
Key Takeaways
- CGRMS (Centralized Grievance Redressal Management System) is the official online portal for PM-JAY complaints.
- You can also call 14555 if you don’t have internet access or want to complain immediately.
- Every complaint gets a reference number so you can track its status later.
- Empanelled hospitals found guilty of wrongly denying treatment or demanding illegal payment have faced fines and de-empanelment in reported cases.
How to File a Complaint via CGRMS
- Go to the CGRMS PM-JAY portal and select “Register Your Grievance.”
- Choose PMJAY as the scheme, and enter your personal and Ayushman Card details.
- Provide the hospital’s name and a clear description of what happened — including the reason given for refusal, and the name of the staff member or doctor involved, if known.
- Upload any supporting documents: hospital slips, prescriptions, payment receipts, or a written rejection.
- Submit and note the complaint reference number for tracking.
Filing a Complaint by Phone
If you’d rather not use the online portal, call the 14555 helpline, select your language, and explain the situation to the operator. Have your Ayushman Card number and hospital details ready — the process mirrors the online form, just conducted verbally. See our PM-JAY helpline guide for more on what else 14555 can help with.
What to Document Before You Complain
| Document | Why it helps |
|---|---|
| Hospital admission/OPD slip | Proves you sought treatment at that facility |
| Doctor’s prescription or notes | Establishes the medical context of your visit |
| Written rejection or refusal note | Direct evidence the hospital denied cashless treatment |
| Payment receipt (if you were charged) | Supports a claim for reimbursement or fine against the hospital |
What Happens After You Complain
Your complaint is routed to the relevant State Health Agency or district grievance officer for review. Depending on the finding, outcomes have ranged from directing the hospital to provide the treatment or refund, to fines, to de-empanelment for repeat or serious violations — enforcement varies by state and case severity, so track your specific complaint status via the reference number rather than assuming a fixed timeline or outcome.
Frequently Asked Questions
How do I complain if a hospital denies me PM-JAY treatment?
File a complaint on the CGRMS portal (cgrms.pmjay.gov.in) or call the 14555 helpline, providing your Ayushman Card number, hospital details, and any supporting documents.
What documents should I keep if a hospital denies treatment?
Keep the hospital slip, doctor’s prescription, any written rejection note, and payment receipts if you were charged — these strengthen your complaint.
Can I track my PM-JAY complaint after filing it?
Yes, every complaint filed through CGRMS or 14555 gets a reference number you can use to check its status later.
What happens to hospitals found guilty of denying PM-JAY treatment?
Outcomes vary by case and state, and have included directives to provide treatment or refunds, fines, or de-empanelment for serious or repeat violations.
Related: PM-JAY Helpline guide, PM-JAY Benefits guide, and PM-JAY Hospital List guide.
