Tender Notice Dt - Department of Health , J&K

ased on basic quality criteria as given in section 8 (a & b). Additionalcriteria may be decided jointly by State Government/ Nodal Agency and theInsurance Company. However, Insurance Company will make efforts tomake sure that a large number of public health care providers areempanelled. The providers will be paid as per the pre-defined package rates.These package rates will be same for both public and private providers.h. Draft Template for Agreement between Insurer and Hospital has beenprovided in Annexure 10. In case of any modification, the insurer willneed to take prior approval from the State Nodal Agency.i. Delisting of Hospitals:Network Hospital would be de-listed from the RSBY network if, it is foundthat guidelines of the Scheme are not followed by them and services offeredare not satisfactory as per laid down standards.j. List of Empanelled Health Facilities to be Submitted at the time ofSigning of Contract:At the time of signing of the contract with the State Government, the Insurershould provide list of empanelled health providers with the following details:a. A list of empanelled health facilities, within the State which have agreedto be a part of RSBY network, in the format given in Annexure 9. For thehospitals which will be empanelled after signing of the contract, theInsurer will need to submit this information related to empanelment atperiodic intervals of 1 month, 3 months and 6 months of agreement tothe State Government/ Nodal Agency.8. Services Beyond Service Area:8.1 The Insurer undertakes that it will, within one month of signature ofagreement with State Government, empanel health Providers beyondthe territory of the districts covered by this Tender for the purposes ofproviding benefits under RSBY to Beneficiaries covered by this Tender.Such providers shall be subject to the same empanelment process andeligibility criteria as provided within the territory of aforementioneddistricts, as outlined in Section 8 of this Tender. If the hospitals in theneighboring districts are already empanelled under RSBY, theninsurer shall provide a list of those hospitals to the StateGovernment/ Nodal Agency.8.2 To ensure true portability of smart card so that the beneficiary can getthe treatment anywhere across India in a RSBY empanelled hospital,the Insurer shall enter into arrangement with other Insurancecompanies for allowing sharing of network hospitals, transfer of claim& transaction data arising in areas beyond the service area. To ensure12