Manual for District Empanelment Committee & State Empanelment Committee AB-MGRSBY, Rajasthan State Health Assurance Agency

2020

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Empanelment of Health Care Providers

The health care services under AB MGRSBY Y would be provided to its beneficiaries

through a network of public and private healthcare providers. Given the above, detailed

guidelines have already been issued vide no. 778 on 02.07.20. These guidelines contains

empanelment criteria required by the hospital, constitution and responsibilities of District

Empanelment Committees (DECs) and State Empanelment Committee (SEC) etc.

Hospitals desirous of empanelment will submit online application which will be scrutinized

initially by DEC and then SEC. Final decision on empanelment will be taken by SEC. DEC

will examine the application submitted by private hospital and after necessary inspection

recommend it to SEC for empanelment or rejection of application. This entire process shall

be coordinated through an online portal “Hospital Empanelment Management

(HEM).”

Online Empanelment through HEM Portal

A web-based platform Hospital Empanelment Management (HEM) have been

developed for registration of a healthcare provider willing to get empanelled under

the AB MGRSBY.

Steps of online empanelment-

1. Submission of online application by the hospital: The hospital will apply

through HEM web portal https://hospitals.pmjay.gov.in/rajasthan as the first

step of empanelment. This application includes details on following fields:-

a) Hospital Basic Information:

b) Financial Details:

c) Specialty offered by hospital:

d) Licenses and Certifications:

e) Civil Infrastructure:

f) Medical Infrastructure:

g) General Services:

h) Man-Power Details:

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2. District Empanelment Committee (DEC): DEC will undertake field-based

inspection/verification of the information and documents provided by the

hospital. The team will recommend whether hospital should be empanelled or

not based on their field-based inspection/verification report.

3. State Empanelment Committee (SEC): To finalize whether hospital should

be empanelled or not based on the recommendation of DEC.

STEP 1: Go To https://hospitals.pmjay.gov.in/rajasthan address bar of the browser.

View of AYUSHMAN BHARAT MAHATMA GANDHI RAJASTHAN SWASTHYA BIMA YOJANA Home page as shown in Screen shot 1.

Screen Shot 1

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STEP 2: At the extreme right top area we can see “Dept. User Login”. After clicking on it the login screen will appear (As shown in Screenshot 2)

Screen shot 2

STEP 3: After filling in the login details & capatcha user will click on login. After which the portal will redirect you to Dashboard of the logged in ID (As shown in Screenshot 3.1 & 3.2)

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Screen shot 3.1

Screen shot 3.2

STEP 4: Next towards left there are two major headings “Empanelment” & “Application Enhancement” (As shown in Screenshot 4)

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Screen shot 4

STEP 5: Next towards left we will click on “Empanelment” headings and options under it will be visible (As shown in Screenshot 5)

Screen shot 5

STEP 6: Now we will click on “view submitted applications”. After which we will see the filter or search application to find any particular hospital on first part of the page and last part of page is having the list of submitted applications (As shown in Screenshot 6)

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Screen shot 6

STEP 7: Now we will click on “Hospital ID” to see the application filled by hospital and the details which are filled by hospitals in different heads (As shown in Screenshot 7)

Screen shot 7

STEP 8: Now we will check all the heads of particular “Hospital ID” which we opened to see the application filled by hospital and check the provided details (As shown in Screenshot 8.1)

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Screen shot 8.1

We can check all the attachments in the application for example license, MoU etc. in “Attachments” tab we can find all the scanned or attached images by hospital during the registration time (As shown in Screenshot 8.2)

Screen shot 8.2

STEP 9: Now we will click on “Worklist” head under “Empanelment” which also let us see all the details After which we will see the filter or search application to find any particular hospital on first part of the page and last part of page is having the list of submitted applications with

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current action on application (As shown in Screenshot 9.1)

Screen shot 9.1

After we click on desired hospital ID, we will be redirected to the application page where we can see all the detailed application with all the tabs including “Approve/Reject” tab (As shown in Screen shot 9.2)

Screen shot 9.2

As we click on “Approve/Reject” tab (As shown in Screenshot 9.3) we will get options of “Workflow Details”, “Physical Verification Report Attachment” & “Remarks” (As shown in screen shot 9.3)

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Screen shot 9.3

To attach Physical verification Report, we can upload multiple reports & in remark column we can write up the remarks during visit or we can paste YouTube link of physical verification video which was made by DEC member during verification visit.

The last option on the page is having three action type (As shown in Screenshot 9.4)

The options are:

a. Recommend Reject

b. Recommend Approve

c. Clarification required from Hospital

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Screen shot 9.4

STEP 10 : Now we will click on “View Drafted Applications ” head under “Empanelment” which let us see all the details of Hospital who initiated the empanelment application and how much details have been filled and saved by the hospital there is a filter or search application to find any particular hospital on first part of the page and last part of page is having the list of submitted applications (As shown in Screenshot 10)

Screen shot 10

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STEP 11: Now we will click on “Application search ” head under “Empanelment” which let us search all Hospitals who either submittd the application or initiated the empanelment application. After searching we can see how much details have been filled and saved by the hospital there is a filter or search application to find any particular hospital on first part of the page and last part of page is having the list of all applications (As shown in Screenshot 11)

Screen shot 11

STEP 12: Now we will click on “Application search” head under “Empanelment” which let us search all Hospitals who either submitted the application or initiated the empanelment application. After searching we can see how much details have been filled and saved by the hospital there is a filter or search application to find any particular hospital on first part of the page and last part of page is having the list of all applications (As shown in Screenshot 12)

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Screen shot 12

STEP 13: Next towards left we will click on “Application Enhancement” headings and options under it will be visible (As shown in Screenshot 3)

Screen shot 13

STEP 14: Next towards left after expansion of “Application Enhancement” options under are “Financial Worklist”, “License & Certifications Worklist”, “Specialties Worklist”, “Manpower Worklist”, “Accreditation Worklist”, “Bed Strength”, “Removal of specialty” & “Hospital Name Worklist” (As shown in Screenshot 14)

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Screen shot 14

STEP 15: Next under “Application Enhancement” options we will click “Financial Worklist” (As shown in Screenshot 15) First part is search application where we can search a particular Hospital application & Second part is where the list of applications where hospital applied for Financial changes to District Empanelment Committee

Screen shot 15

STEP 16: Next under “Application Enhancement” options we will click “License & Certifications Worklist” (As shown in Screenshot 16) First part is search application where we can search a particular Hospital application & Second part is where the list of applications where hospital applied for License & Certifications changes to District Empanelment Committee

Screen shot 16

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STEP 17: Next under “Application Enhancement” options we will click “Specialties Worklist” (As shown in Screenshot 17) First part is search application where we can search a particular Hospital application & Second part is where the list of applications where hospital applied for upgrade in Specialties to District Empanelment Committee

Screen shot 17

STEP 18: Next under “Application Enhancement” options we will click “Man Power Worklist” (As shown in Screenshot 18) First part is search application where we can search a particular Hospital application & Second part is where the list of applications where hospital applied for upgradation in Man Power to District Empanelment Committee

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Screen shot 18

STEP 19: Next under “Application Enhancement” options we will click “Accreditation Worklist” (As shown in Screenshot 19) First part is search application where we can search a particular Hospital application & Second part is where the list of applications where hospital applied for changes in Accreditation to District Empanelment

Committee

Screen shot 19

STEP 20: Next under “Application Enhancement” options we will click “Bed Strength Worklist” (As shown in Screenshot 19) First part is search application where we can search a particular Hospital application & Second part is where the list of applications where hospital applied for addition or subtraction in Bed Strength to District

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Empanelment Committee

Screen shot 20

STEP 21: Next under “Application Enhancement” options we will click “Removal of Specialty” (As shown in Screenshot 21) First part is search application where we can search a particular Hospital application & Second part is where the list of applications where hospital applied for Removal of Specialty to District Empanelment Committee

Screen shot 21

STEP 22: Next under “Application Enhancement” options we will click “Hospital Name Worklist” (As shown in Screenshot 22) First part is search application where we can search a particular Hospital application & Second part is where the list of applications where hospital applied for Changes in Hospital Name to District Empanelment

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Committee

Screen shot 22