Healthcare Access

TPA & Health Insurance Empanelment

Ensuring Hospital Empanelment for Cashless, Seamless, and Patient-Centric Healthcare Access.

About TPA & Health Insurance Empanelment

In today’s healthcare ecosystem, TPA (Third Party Administrator) and Health Insurance Empanelment play a vital role in ensuring cashless treatment, transparent billing, and timely reimbursements for patients.

Hospital Empanelment with leading insurance companies and TPAs enhances a hospital’s credibility, expands patient reach, and supports compliance with NABH, NABL & JCI standards.

What is TPA Empanelment?

A Third Party Administrator (TPA) is an authorized organization that manages health insurance claims and provides support for cashless hospitalization on behalf of insurance companies.

It allows hospitals to provide cashless treatment to insured patients while maintaining transparency, quality, and documentation standards required by Accreditation bodies.

Importance According to Accreditation Standards

Under NABH, NABL & JCI guidelines, organizations must ensure:

Transparency

Authenticity in billing and claim settlement.

Information

Availability of patient rights regarding insurance coverage.

Ethics

Ethical processes for admissions to discharges under insurance.

Grievance

Mechanisms for redressal related to insurance services.

Benefits of Empanelment

Hospital Cashless Treatment Facility

Enables insured patients to receive timely care without financial burden.

Improved Patient Satisfaction

Streamlined admission, approval, and discharge processes build trust.

Increased Revenue

Expands the hospital’s patient base through multiple insurance networks.

Efficient Claim Management

Simplified documentation and prompt reimbursements through defined workflows.

Compliance with Standards

Promotes ethical billing and transparent communication.

Enhanced Credibility

Association with reputed TPAs builds confidence among corporate clients.

Major TPA & Insurance Companies

We support empanelment with a wide network including:

Insurance Companies Third Party Administrators (TPAs)
Star Health InsuranceMedi Assist India TPA Pvt. Ltd.
ICICI LombardParamount Health Services TPA
HDFC ERGOVidal Health TPA
Bajaj AllianzRaksha TPA
Aditya Birla HealthFamily Health Plan (FHPL)
Reliance GeneralHealth India TPA
Care Health InsuranceMDIndia Healthcare Services
SBI Health InsuranceMedSave Healthcare TPA
TATA AIGGood Health TPA

...and many more as per hospital location and eligibility.

Our Empanelment Support Services

At DianaMik Hospital Management Consultancy LLP, we provide end-to-end consultancy to expand your reach.

  • Identification of suitable TPAs and insurers for primary empanelment
  • Preparation of application and supporting documentation
  • Coordination with companies for panel inclusion
  • Establishment of cashless hospitalization protocols
  • Guidance on pre-authorization, claim submission, and settlement
  • NABH-aligned documentation templates (AAC, COP, IMS)
  • Training of Hospital front-office and billing staff

Our Process

01

Assessment

Hospital Gap Assessment & Document Review

02

Application

Empanelment Application Submission process

03

Audit

Audit & Approval Coordination

04

Integration

TPA required Software Integration (if applicable)

05

Training

Staff Training on patient Claim & Cashless Procedures

06

Support

Post-Empanelment Compliance Support

Integration with NABH Standards

NABH Chapter Clause Objective
Access, Assessment (AAC) AAC.4 Transparent communication regarding tariffs and coverage
Information Management (IMS) IMS.5 Secure handling of insurance data and patient records
Continuous Quality (CQI) CQI.3 Tracking turnaround time of claims and pre-authorizations
Patient Rights (PRE) PRE.2 Ensuring patients are aware of insurance coverage and exclusions

Why Choose Us?

100+

Hospitals Empaneled

Expertise

In NABH & TPA Documentation

Support

Training for Billing Teams

We bridge the gap between hospital and insurance companies — making quality care accessible for every insured patient.

Ready to expand your network?

Get Empanelled Today