SPAW Hospital

Empanelment's TPAs

Hospital Empanelment with TPA | GIPSA Empanelment

Hospital Empanelment with TPA and GIPSA Empanelment is the process through which hospitals are authorized to provide cashless treatment to insured patients by partnering with Third-Party Administrators (TPAs) and public sector insurers under the General Insurance Public Sector Association (GIPSA). This empanelment allows hospitals to be part of insurance networks, offering standardized treatment packages, faster claim settlements, and increased patient footfall. It ensures better access to healthcare for policyholders while enhancing the hospital’s credibility, visibility, and operational efficiency.

CURRENT EMPANELMENT LIST OF OUR HOSPITAL

S.NO NAME Of TPA
PRIVATE INSURANCE
1GIPSA / PPN INSURANCE
2NATIONAL INSURANCE CO.
3THE NEW INDIA INSURANCE
4ORIENTAL INSURANCE CO.
5UNITED INDIA INSURANCE CO.
6VIPUL TPA
7VIDAL HEALTH TPA
8PARAMOUNT TPA
9GOOD HEALTH TPA
10RAKSHA TPA
11PARK MEDICLAM
12MEDIASSIST TPA
13EAST WEST TPA
14FHPL TPA
15ERIXON TPA
16MD INDIA TPA
17UNITED HEALTH PAREKH TPA
18HEALTH INDIA INSURANCE TPA
19SAFEWAY TPA
20HERITAGE TPA
21GENSIS TPA
22ALANKIT TPA
23MEDICARE TPA
24FOCUS TPA
25MEDSAVE TPA
26VOLO HEALTH INSURANCE TPA
27NAVI GENERAL INSURANCE
29STAR Health and Allied Insurance Co. Ltd
30SBI General Insurance
31Aditya Birla Health Insurance
32ICICI Lombard General Insurance
33Reliance General Health Insurance

What is Hospital Empanelment with TPA?

Hospital Empanelment with TPA refers to the process where hospitals get formally associated with Third-Party Administrators (TPAs) to offer cashless treatment to insured patients. It allows policyholders to avail of medical services at the hospital without making upfront payments, as the TPA settles bills directly with the hospital.

Key Benefits for Hospitals:

  • Increased patient footfall

  • Quicker claim settlements

  • Association with major insurance companies

  • Enhanced reputation and trust

Key Requirements:

  • Valid hospital license and registration

  • Necessary infrastructure (beds, ICU, labs, etc.)

  • Qualified medical professionals

  • NABH/NABL accreditation (preferred)

  • Standardized billing and IT systems

What is GIPSA Empanelment?

GIPSA stands for General Insurance Public Sector Association, an association of 4 leading public sector insurance companies in India:

  1. United India Insurance

  2. National Insurance

  3. Oriental Insurance

  4. New India Assurance

These companies, along with select TPAs, have formed Preferred Provider Networks (PPN) for hospital empanelment.

GIPSA Empanelment Highlights:

  • Stringent selection criteria

  • Standardized treatment packages and rates

  • Only quality hospitals with defined infrastructure and service standards are empaneled

  • Empaneled hospitals must agree to fixed rates for specific procedures (called PPN package rates)

Why GIPSA Empanelment is Important:

  • Access to a large base of insured patients from PSU insurance policies

  • Enhanced brand credibility due to association with government insurers

  • Opportunity to offer cashless services for CGHS/ESIC/PSU policyholders

  • Part of a Preferred Provider Network (PPN) for better visibility

Empanelment Process Overview:

  1. Application Submission: Hospital submits an application to the TPA or GIPSA panel.

  2. Documentation: Includes licenses, infrastructure details, doctors’ qualifications, and service capabilities.

  3. Inspection & Audit: Site visits and evaluation by the TPA or GIPSA panel.

  4. Agreement Signing: If approved, a contract is signed, detailing terms and package rates.

  5. Listing: Hospital is listed in the insurer/TPA’s network for cashless services.

Common Documents Required:

  • Hospital registration certificate

  • Fire and biomedical waste certificates

  • NABH/NABL certificate (if available)

  • List of doctors and qualifications

  • Infrastructure & services report

  • Bank details & PAN

  • Past clinical records or quality metrics