According to the guidelines issued by “Insurance Regulatory and Development Authority (IRDA)”, if a healthcare facility wants to be recognized as a hospital, then it will be defined as:-
If an institution has “in –patient” facilities and provides daycare treatment to people for an illness or an injury and is already 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 fulfills the following criteria:-
- The hospital is required to have a highly qualified nursing staff, for 24 hours a day.
- The hospital is required to have at least 10 beds for it’s patients, who are undergoing medical treatment in the hospital. The 10-bed rule is applicable in towns that a have population of less than 10,00,000.
- If the population of the town exceeds 10,00,000, then a minimum of 15 beds is required for patients at the hospital.
- The hospital staff must be composed of highly trained and qualified medical practitioners, who are available 24 hrs a day.
- The hospital is required to have a fully functioning operation theatre, where all the surgical procedures will be performed.
- The hospital is also required to maintain a fully detailed record of it’s patients. And also make the patient records easily available to the concerned personnel of an insurance company.
The above-mentioned point constitutes the minimum criteria for any healthcare facility to be recognized as a hospital and different insurance companies can have different provider network requirements, as these insurance companies have their dependency on several factors such as “needs of their business, customer service quality, policy terms, and conditions”.
If you get your hospital empanelled, then you will not only increase the trust of the patients in your hospital but also maintain a good position in society. The tag of empanelment on your hospital will assure the patients, that you are fully committed towards the betterment of their health and all your medical services are up to the current benchmarks. Hospital empanelment covers all the broader factors like “TPA, insurance, CGHS, GIPSA empanelment”.