TPA's & CGHS ONBOARDING SERVICES

“Who We Serve” 

What Are TPA & CGHS Panels?

TPAs (Third Party Administrators)

• Licensed intermediaries authorized by IRDAI to process health insurance claims

• Being empaneled allows your facility to serve insured patients without upfront payments, ensuring faster admissions, greater trust, and assured reimbursements

• Popular TPAs in India: Medi Assist, Vidal Health, MDIndia, Raksha TPA, Paramount, Heritage Health, FHPL, etc.

CGHS (Central Government Health Scheme)

• India’s flagship government health scheme for Central Government employees, pensioners, MPs, judges, and other entitled categories

• CGHS-empaneled hospitals and labs receive high-volume patient footfall and timely reimbursements under defined service packages and rates

Our Complete TPA & CGHS Onboarding Solution:

Empanelment Eligibility & Scope Identification:

• Assess facility’s services, infrastructure, and documentation

• Advise on suitable TPAs and CGHS panels based on setup & goals

• Classification guidance: NABH status, bed capacity, specialties, tariffs

Application Preparation & Portal Filing:

• Accurate online & offline documentation filing

• Scope declaration, MoU sign-off, and rate package selection

• Uploading hospital profile, clinical manpower, licenses, and photos

• Full guidance on CGHS Empanelment Portal

Package Rate Structuring & Negotiations:

• Mapping service rates with CGHS or insurer-prescribed tariffs

• Assistance in negotiating special packages for complex treatments

• Aligning diagnostics, procedures, and room tariffs with government norms

Infrastructure & Compliance Readiness:

• Ensure facility meets minimum CGHS/TPA requirements

• Signage, biomedical waste compliance, fire NOC, HR readiness

• Preparation for surprise audits & inspection visits by officials

SOP Setup for Cashless Billing & Claim Workflow:

• Build robust internal ecosystem for cashless treatment

• TPA Desk SOPs: Pre-auth, admission, discharge, billing

• CGHS Desk SOPs: Registration, e-referrals, treatment logs, invoicing

• Claim Documentation Formats: ICD codes, itemized bills, file tracking

• Audit File System: Record-keeping for 6+ years

Staff Training & Capacity Building:

• Real-time CGHS patient registration and validation

• TPA software usage, forms, and coding

• Pre-authorization documentation and online claim submissions

• Red-flag alerts to prevent claim rejections

Post-Empanelment Support:

• Onboarding CGHS beneficiaries into your system

• Claim management SOPs

• Periodic compliance health-checks

• Support for rate revisions, scheme renewals, and MoU updates

Who Should Opt for TPA & CGHS Onboarding?

• Multispecialty & Super-Specialty Hospitals

• Small & Medium-Sized Nursing Homes

• Pathology & Radiology Laboratories

• Standalone Clinics & Day Care Centres

• Dental, Eye, ENT, and AYUSH Care Units

Note: Services tailored to your facility scale, region, and specialties — from 10-bed clinics to 300-bed hospitals

Why Choose Vivekanand Healthcare?

• Specialized experience in Government & Insurance Panels

• Handled 100+ CGHS/TPA onboardings across India

• One-stop documentation, portal, and backend support

• Field-tested SOPs, claim templates, and audit-proof formats

• 360° post-empanelment support — not just sign-up and forget

Call to Action:

Expand Your Healthcare Reach — The Smart Way
With proper TPA and CGHS onboarding, your facility becomes eligible to serve thousands of insured patients and government beneficiaries — zero financial friction, maximum credibility, and sustained business growth.

Book your panel onboarding consultation today and make your facility cashless-ready and compliant with VHASPL’s expert guidance.