Standards and Benchmarks for the Hospitals in the Provider Network

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Standards and Benchmarks for the Hospitals in the Provider Network — 20 Jul 2022 | IRDAI circular · Complied AI

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भारतीय बीमा विनियामक और विकास प्राधिकरण
INSURANCE REGULATORY AND
DEVELOPMENT AUTHORITY OF INDIA

Ref No: IRDAI/HLT/CIR/MISC/150/7/2022

20^th July, 2022

To
All Insurance Companies and Third Party Administrators (except ECGC, AIC)

Sub: Standards and Benchmarks for the Hospitals in the Provider Network

Reference is invited to IRDAI Circular ref: IRDAI/HLT/REG/MISC/199/07/2021 dated 23^rd July, 2021 on the captioned subject with respect to the standards and benchmarks at clause (a)(i) and (ii) and clause (b) of Chapter IV of the Guidelines on Standardisation in Health Insurance under Section I of Master circular (ref. IRDAI/HLT/REG/CIR/193/07/2020 dated 22^nd July, 2020).
In partial modification of the above guidelines, in order to enhance the scope for offering cashless facility across the length and breadth of the country, the insurers are now empowered to empanel the network providers that meet the standards and benchmarks criteria as specified by their respective boards. While specifying the criteria, the board of insurers shall, amongst others, consider especially the minimum manpower and healthcare infrastructure facilities.
The board approved empanelment criteria shall be published in the website of the insurers from time to time.
While empaneling network providers for cashless facility, insurers are also advised to focus on the delivery of quality healthcare services.
These instructions shall come in to force with immediate effect.
This circular is issued under the provisions of Regulation 31(e) of the IRDAI (Health Insurance) Regulation, 2016.
This has the approval of the competent Authority.

भवदीय,

VENKATASUBRAMANYA RAMESH DEVARAKONDA
Digitally signed by VENKATASUBRAMANYA RAMESH DEVARAKONDA
Date: 2022.07.20 10:30:27 +05'30'

डी.वी.एस. रमेश
मुख्य महाप्रबंधक (स्वास्थ्य)

Sy no. 115/1, Financial District, Nanakramguda, Hyderabad - 500032
Phone: 040-20204000,E mail: health@irdai.gov.in