GIPSA, PPN and Empanelment

GIPSA stands for General Insurance Public Sector Association. True to its name, it is an association comprising four sector general insurance companies:

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GIPSA PPN

GIPSA has this neat PPN network – it's like a bunch of hospitals spread across 12 cities in India. So, whether you're dealing with kidney stones or need an angioplasty, the prices for these medical things are consistent in any PPN hospital.

Going to these hospitals is a smooth ride for your wallet because they make the whole claiming process super easy. It's like giving your health the red carpet treatment without the hassle.

What is PPN?

PPN stands for preferred provider network. It is a special setup by GIPSA, where hospitals that align with their policies and prices join in. To be part of PPN, hospitals have to agree to follow GIPSA rules and operate based on standardized rates. 

Those who sign up for this arrangement become part of the GIPSA family and are referred to as PPN. Currently, there are approximately 540 hospitals across the nation that have opted to be part of GIPSA's network.

GIPSA Empanelment

GIPSA empanelment is like getting a golden ticket into the Preferred Provider Network (PPN) of Public Insurers. Hospitals interested in this can complete and submit GIPSA empanelment forms, along with the necessary documents requested by the insurers. The forms and document requirements can be found on the insurance companies' websites. Once approved, your hospital joins the list of networked hospitals, opening doors to the benefits of being part of the PPN.

Consider these key points before opting for GIPSA services 🧐:

  • Cashless claims are available exclusively in GIPSA-approved Preferred Provider Network (PPN) hospitals.
  • For reimbursement claims from treatment at a PPN hospital, the insurance company follows standard GIPSA rates.
  • If opting for reimbursement from a non-PPN hospital, reimbursement is based on the reasonable and customary clause. This means repayment is in line with the typical cost of the service in a specific area, as determined by your insurer.
  • PPN hospitals are obligated to adhere to standardized rates. If a hospital charges more or denies admission, you can promptly file a complaint with the insurer.

Conclusion

GIPSA, a collaboration of four public sector insurers, has established the Preferred Provider Network (PPN) with around 540 hospitals nationwide. GIPSA empanelment allows hospitals to join PPN, ensuring standardized rates and policies. For policyholders, PPN offers uniform pricing and easy claiming in network hospitals, emphasizing transparency and efficiency in public sector healthcare.

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