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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
Enables insured patients to receive timely care without financial burden.
Streamlined admission, approval, and discharge processes build trust.
Expands the hospital’s patient base through multiple insurance networks.
Simplified documentation and prompt reimbursements through defined workflows.
Promotes ethical billing and transparent communication.
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 Insurance | Medi Assist India TPA Pvt. Ltd. |
| ICICI Lombard | Paramount Health Services TPA |
| HDFC ERGO | Vidal Health TPA |
| Bajaj Allianz | Raksha TPA |
| Aditya Birla Health | Family Health Plan (FHPL) |
| Reliance General | Health India TPA |
| Care Health Insurance | MDIndia Healthcare Services |
| SBI Health Insurance | MedSave Healthcare TPA |
| TATA AIG | Good Health TPA |
…and many more as per hospital location and eligibility.
Our Empanelment Support Services
At DianaMik Hospital Management Consultancy, 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
Assessment
Hospital Gap Assessment & Document Review
Application
Empanelment Application Submission process
Audit
Audit & Approval Coordination
Integration
TPA required Software Integration (if applicable)
Training
Staff Training on patient Claim & Cashless Procedures
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?
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