We are in the process of establishing provider network under tripartite agreements between Insurer-Provider and TPA for extension of cashless facility to Member customers.
As per IRDA Guidelines, a hospital is defined as:
“Any institution established for in-patient care and Day Care Treatment of illness and / or injury and which has been registered as a hospital with the local authorities under the Clinical Establishments (Registration and
Regulation) Act, 2010 or under the enactments specified under the schedule of Section 56 (1) of the said Act OR complies with the minimum, criteria as under:
- Has qualified nursing staff under its employment round the clock,
- Has at least 10 in-patient beds in towns having a population of less than 10,00,000 and at least 15 in-patients beds in all other places,
- Has qualified medical practitioner(s) in charge round the clock
- Has a fully equipped operation theatre of its own where surgical procedures are carried out
- Maintains daily records of each of its patients and makes these accessible to the Insurance Company’s authorized personnel.
In addition to above stated minimum criteria, provider network requirements may vary for different insurers who may lay down additional criteria dependant on their business needs, customer service parameters, policy terms and conditions, utilization and other parameters.
As first step towards provider network development process, HI TPA requires information regarding respective hospital’s facilities, infrastructure and other relevant details as per Empanelment Form, copy attached. Interested providers may fill in the form and mail the same along with necessary Annexures.
after login with all relevant details
Simultaneously hard copy of the duly signed Form along with Annexures in a clearly marked envelope as mentioned above should be sent to:
Provider Network Department,
Health Insurance TPA of India Ltd.,
2nd Floor, Majestic Omnia Building,
A-110, Sector 4 Noida,
Uttar Pradesh – 201301.
Disclaimer: Please note that submission of Empanelment Form both in soft and hard copy is essential for further processing however it should not be construed as binding or leading to empanelment. The empanelment of a hospital as a network provider is governed by advices/requirements of insurers as stated above, completion of rest of the process and mutual agreement on terms and conditions of the tripartite agreement to be signed by the concerned parties.
For any clarification in this regard, you may mail to firstname.lastname@example.org