Hospital Empanelment
Network hospitals may be characterized as those hospitals which take cashless hospitalization into account based on specific conditions. Insurance Empanelment is an important exercise which directly influences increased influx of patients requiring medical treatment/diagnostic intervention.
When you are admitted to a non-network hospital you will need to present your bills to the hospital and seek reimbursement through TPA. To facilitate best and quality medical services to our members, we are always on the look out of good hospitals to include them in our network. We would like to avail your services to serve them better.
Benefits Of Hospital Empanelment
- Increased inclusion in the patient base.
- Access to patients legitimately through other human services partners.
- Providing accommodation to patients with the arrangement of cashless office.
- More believability to the training as hospital empanelment is a through confirmation. procedure and patients see this as acknowledgment uncommonly in instances of government empanelment.
- Brand building exercise for the training.
GOVERNMENT ORGANISATIONS
- CGHS ( Central Government Health Services)
- ECHS (Ex-servicemen Contributory Health Scheme)
- ECIS ( Employee state insurance corporation)
- RGJAY (Rajiv Gandhi Jeevandayee Arogya Yojana)
- MJPJAY (Mahatma Jyotiba phule jan arogya yojana)
- PMJJBY (Pradhan Mantri Jeevan Jyoti Bima Yojana)
- GIPSA (General Insurance Public Sector Association)
- Indian Oil
- MMTC
- ONGC
- BPCL
- IOCL
- AIRINDIA
HOSPITAL EMPANELMENT WITH PRIVATE ORGANIZATIONS
- Mediassist TPA
- Health India TPA Services
- Private Limited MDIndiaTPA
- United Healthcare Parekh TPA
- Paramount Health Services & Insurance TPA Pvt. Ltd
- E Meditek (TPA) Services Ltd.
- Heritage Health TPA Pvt. Ltd.
- Focus Healthservices TPA Pvt. Ltd.
- Medicare TPA Services (I) Pvt. Ltd.
- Family Health Plan (TPA) Ltd.
- Raksha TPA Pvt. Ltd.
- Vidal Health TPA Private Limited
- Anyuta TPA in Healthcare Pvt. Ltd.
- East West Assist TPA Pvt. Ltd.
- Med Save Health Care TPA Ltd.
- Health Insurance TPA of India Ltd.
- Reliance industries
- Tata steel
- Wipro
- TC
Empanelment Criteria
- Hospitals should be available 24X7 consisting of fully qualified Medical Staff and Doctor(s) around the clock with 24hrs admission facility.
- Ought to have a minimum of 2 permanent doctors on its roll and a minimum of one postgraduate doctor offered either permanently or panel basis. The hospital should even have a minimum of one DM Doctor for every super-specialty catered to by the Hospital.
- Should have a minimum of 3 permanent trained nurses, who are registered with the Nursing Council of India.
- Hospitals should have the facility of in-house pharmacy and pathology lab or tie-ups for pathological tests/ pharmacies to ensure fully cashless treatment of the Beneficiaries.
- Ought to have a minimum of 15-bed indoor treatment capability in conjunction with full-fledged Operation Theatre and intensive care unit. Eye Hospitals providing OPD procedures like cataract and different eye surgeries should have at least fifteen beds.
- Must establish a facilitate table at In-patient (IPD) reception, for the BGSSS beneficiaries.
- Ought to supply free/discounted OPD services to the members as a price additional service. (Shall not be binding upon the hospital)
- Shall comply with the rates/duration for varied procedures as mentioned in the Bhai Ghanhya Schedule of Rates.
- Shall install necessary infrastructure like PC, fax machine, software, hardware, etc. at its cost for implementing E- Preauthorization and facilitating on-line transmission of tomography images/ modalities and determine minimum 2 coordinators to coordinate with patient, treating doctor, TPA, and HOD of the hospital.
- Shall offer the most popular and priority admission to BGSSS beneficiaries and make sure that hospitalization of the members is cashless i.e. organize for funds for the medicines/ investigations not offered with the hospital or have a necessary tie-up with the diagnostic centers/pharmacies for the facilities not offered within the hospitals.
- Shall supply diagnostic services at discounted rates to the members (Shall not be binding on the hospital).
- TPA associate degreed insurance underwriter shall enter into an MOU with the network Hospital, which shall be valid for the amount of policy set up. The Bhai Ghanhya Schedule of Rates, a kind associate degree is an integral part of MOU entered between the TPA and the Network Hospital for the policy set up.
- The mandatory formalities to be completed by the provider Network for electronic mode of payment:
1. Duly filled Contact details sheet.
2. Duly filled NEFT/EFT Mandate kind.
3. Duly filled payee Name Confirmation Format
4. Sample Cheque(canceled Cheque)
