Private Hospital Refused Swasthya Sathi Card? How to Lodge a Grievance (2026)

Standing at the hospital reception, you hear — “we don’t take Swasthya Sathi cards” or “you’ll have to pay cash for medicines and tests before admission.” Hundreds of families in West Bengal go through this every day. But know this — turning away a cardholder patient at an empanelled hospital or demanding money beyond the package is against the rules, and there is a defined process for complaining about it. This article gives you that step-by-step process.

Short answer: If the hospital refuses the card or asks for cash, first talk to the hospital’s Swasthya Sathi / TPA desk. If that doesn’t work, immediately call the toll-free 1800 345 5384 number and complain with the hospital’s name and the patient’s URN number, or file a written complaint in the ‘Lodge Grievance’ section of the official Swasthya Sathi mobile app.

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Which Hospital Practices Are Against the Rules?

First understand what is grounds for a complaint:

• Refusing admission: Turning a cardholder patient away from an empanelled hospital saying “Swasthya Sathi doesn’t work here” even when beds are available.
• Demanding cash for medicines-tests: Asking for items within the package to be bought outside, or demanding cash outright. These costs are included in the package rate.
• Pre-admission test charges: Charging separately, outside the package, for necessary tests done just before admission.
• False claims: Saying “treatment for your condition isn’t in the package” — when that treatment is in the package list. The package list can be viewed on the swasthyasathi.gov.in portal.
• Pushing you outside the panel: Telling you to go to another hospital without any valid reason, so the patient is forced to pay cash for treatment.

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What to Do Immediately: The Step-by-Step Grievance Process

Standing in the hospital lobby, read this section on your phone and tick off the steps.

Step 1: The hospital’s Swasthya Sathi / TPA desk

Large private hospitals have a separate desk or TPA (Third Party Administrator) officer for Swasthya Sathi billing. If the reception refuses, go there. The patient’s URN (Unique Registration Number) is written on the back of the card. If they verbally say “it won’t work,” ask for the reason in writing — often the problem is resolved right there.

Step 2: The toll-free helpline 1800 345 5384

This is the fastest method. Call and provide:

• The hospital’s name and address, district
• The patient’s name and 13-digit URN number
• Exactly what is happening (refusal of admission / cash demand / outside tests)

Note the date and time of the call and the complaint’s reference number — it will help in the follow-up.

Step 3: Complaint on the Swasthya Sathi mobile app

Download the official ‘Swasthya Sathi’ app from the Google Play Store. Log in with the registered mobile number and write the complaint in the ‘Lodge Grievance’ section, mentioning the hospital’s name. A written complaint stays on record, so in many cases it is even more effective than the helpline.

Step 4: Online complaint on the portal

A complaint can also be made through the Grievance section of the swasthyasathi.gov.in portal. Save the reference number.

Step 5: If it still isn’t resolved

If there is no resolution even after the helpline and app complaints, contact with your evidence:

• The district’s CMOH (Chief Medical Officer of Health) office
• The Swasthya Sathi wing of Swasthya Bhawan in Salt Lake Sector V

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What to Gather to Prove the Complaint

• The patient’s Swasthya Sathi / MMSBY / Ayushman card (or URN number)
• The hospital’s outdoor or emergency ticket — this proves you really did visit the hospital
• The doctor’s Admission Advice — stating the patient must be admitted
• If any money was already paid, its bill or at least a paper receipt
• If conversations happened on the phone, notes or a recording if possible, and a photo of the hospital’s name board

Remember: The more evidence, the faster the complaint is resolved. If you pay cash without taking a receipt, getting a refund later becomes difficult — so start the complaint process before paying.

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What Happens If the Complaint Is Proven?

If the health department’s investigation proves the complaint:

• The hospital is fined and can be ordered to refund the money taken from the patient’s family.
• Repeated proven complaints can lead to the hospital’s removal from the Swasthya Sathi / MMSBY panel — meaning no cardholder patient will get cashless treatment at that hospital, a serious business loss for it.

That is exactly why many hospitals immediately fall in line as soon as they hear a complaint is being made to the helpline.

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Extra Caution During This Time of Scheme Change

After Swasthya Sathi was split into MMSBY and Ayushman Bharat in 2026, some hospitals are refusing cards saying “Swasthya Sathi has shut down.” Remember:

• Until the new PVC card arrives in hand, the old Swasthya Sathi card and URN number remain valid.
• To know which scheme your card went to, read: Is the Swasthya Sathi Card Being Cancelled in 2026?
• If you need to apply afresh under the new schemes, see: Apply Online for MMSBY and the rules for porting to Ayushman Bharat.

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Helpline and Useful Links

• Toll-free helpline: 1800 345 5384
• Official portal: swasthyasathi.gov.in
• Package list: In the portal’s Package section — check before complaining whether your treatment is in the package

Do not pay any “Swasthya Sathi grievance” app, website or agent other than the official app or portal to lodge a complaint — complaining is completely free.

See which hospitals in your district accept the card: Swasthya Sathi / MMSBY / Ayushman Bharat Hospital List