Empanelment with TPAs and government schemes like CGHS, DGEHS, ECHS, Ayushman Bharat, and GIPSA panels enhances patient access, cashless facility availability, and overall hospital revenue. A Healthcare consultancy helps manage eligibility, documentation, negotiations, and process integration to ensure smooth onboarding and long-term compliance.
Choose consultants offering end-to-end support, including:
Identification and prioritization of empanelment opportunities (TPA, CGHS, GIPSA, ECHS, DGEHS, Ayushman)
Eligibility assessment and application preparation
Rate negotiation and MoU signing
Coordination with empanelment authorities
SOPs for cashless billing, pre-auth, and claims
Training for the billing, insurance desk, and front office teams
Select consultants with strong experience in:
GIPSA (General Insurance Public Sector Association) empanelment
CGHS (Central Government Health Scheme)
DGEHS (Delhi Government Employees Health Scheme)
ECHS (Ex-Servicemen Contributory Health Scheme)
Ayushman Bharat (PM-JAY) scheme
TPAs like Medi Assist, FHPL, Vidal Health, etc.
Compliance with IRDAI and National Health Authority (NHA) guidelines
Ensure the consultant can customize services for:
Eye hospitals, diagnostics, surgical centers, maternity homes, or multispecialty setups
NABH-accredited or entry-level hospitals seeking empanelment as a growth strategy
Hospitals in Tier 2/3 cities aiming for government empanelments to expand patient reach
Empanelment consultancy cost varies by service scope and number of panels:
| Service Scope | Approx. Cost (INR) |
|---|---|
| 5–10 TPA Empanelments | ₹1.5–3 lakhs |
| CGHS/GIPSA/ECHS/DGEHS Empanelment | ₹2–4 lakhs per panel |
| Ayushman Bharat (PM-JAY) Registration | ₹1.5–3 lakhs |
| Complete Empanelment Desk Setup | ₹3–6 lakhs |
Additional costs may apply for post-empanelment support, follow-ups, and integration with hospital billing systems.
Consultants should offer:
Pre-authorization and billing staff training
SOPs and documentation templates for each panel
Dashboard & claim tracking process setup
HIS/ERP integration with empanelment workflows
Claim rejection audit and resolution support
Post-empanelment handholding for 3–6 months, including renewal coordination