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Care Insurance

Hospital Basic Information check_circle

  • Enter Valid Hospital Name
  • Enter Valid Address
  • Enter Valid Address
  • Enter Valid Location
  • Select State
  • Select District
  • Select City
  • Select Pincode
  • Enter Latitude
  • Enter Longitude
  • Enter valid Email Id
  • Enter valid PAN Number
  • Enter valid Name as per PAN
  • Enter valid Rohini Id
  • Enter Rohini Validity From
  • Enter Rohini Validity
  • Select Ownership
  • Enter valid OPD Timing
  • Enter valid OT Timing
  • Select Accident & Emergency - 24/7
  • Enter valid Emergency Time

Contact Details

  • Enter valid Email Id
  • Enter valid Landline Number
  • Enter valid Mobile Number
  • Enter valid Email Id
  • Enter valid Landline Number
  • Enter valid Mobile Number
  • Enter valid Email Id
  • Enter valid Landline Number
  • Enter valid Mobile Number
  • Enter valid Email Id
  • Enter valid Landline Number
  • Enter valid Mobile Number
  • Enter valid Email Id
  • Enter valid Landline Number
  • Enter valid Mobile Number
  • Enter valid Email Id
  • Enter valid Landline Number
  • Enter valid Mobile Number Enter valid Mobile Number
  • Enter valid Email Id
  • Enter valid Landline Number
  • Enter valid Mobile Number
  • Enter valid Email Id
  • Enter valid Landline Number
  • Enter valid Mobile Number

Civil Infrastructure check_circle

  • Enter Valid Age of the building
  • Enter Valid Circulation Area
  • Enter Valid Total Area
  • Select Building Type

Pharmacy

  • Select Pharmacy
  • Enter Valid Contact Number

Laboratory/Pathology services

  • Select Laboratory/Pathology services
  • Enter Valid No of Consultants
  • Choose correct file List of equipment (Make/Model) & Services available (Laboratory) File is Uploaded. check_circle
  • Enter Valid Contact Number

Financial Details check_circle

  • Type of Account
  • Enter Valid IFSC Code
  • Enter Valid Bank Name
  • Enter Valid Payee Name
  • Enter Valid Account Number
  • Choose correct file Cancel Cheque Copy* File is Uploaded. check_circle
  • Choose correct file Hospital SOC/Rate List File is Uploaded. check_circle

Healthcare Facility check_circle

  • Select Cardiology
  • Select Above
  • Select Dermatology
  • Select Above
  • Select General medicine
  • Select Above
  • Select Gastroenterology
  • Select Above
  • Select Nephrology
  • Select Above
  • Select Neurology
  • Select Above
  • Select Oncoclogy
  • Select Above
  • Select Paediatrics
  • Select Above
  • Select Psychiatry
  • Select Above
  • Select Pulmonology
  • Select Above
  • Select Community health
  • Select Above
  • Select Palliative medicine
  • Select Above
  • Select Geriatric care
  • Select Above
  • Select Family medicine
  • Select Above
  • Enter Valid any other

Surgical Specialities

  • Select cardio-thoracic
  • Select Above
  • Select ENT
  • Select Above
  • Select Gastroenterology
  • Select Above
  • Select General Surgery
  • Select Above
  • Select Neurosurgery
  • Select Above
  • Select obstetric & gynaecology
  • Select Above
  • Select Oncology
  • Select Above
  • Select Opthalmology
  • Select Above
  • Select orthopedics
  • Select Above
  • Select Robotic Surgery
  • Select Above
  • Select paediatrics surgery
  • Select Above
  • Select plastic surgery
  • Select Above
  • Select urology
  • Select Above
  • Select vascular surgery
  • Select Above
  • Enter Valid any other

Emergency Services

  • Enter Valid Emergency ward
  • Enter Valid Minor/Major OT
  • Select trauma centre
  • Select ER maintained by qualified doctors

Clinical Support

  • Select Supportive Services
  • Select Radiography
  • Select Clinical Pathology
  • Select Cytology
  • Select Histopathology
  • Select Ventilator
  • Select Endoscopy
  • Select Hematology
  • Select Stress Test
  • Select Chemist in House
  • Select Blood Fractional Facility
  • Select Chest X-ray
  • Select Pet scan
  • Select Pathology
  • Select Audiometry

Dietary Services

  • Select Dietary Services
  • Select In-house with qualified dietician

Non Clinical Support Service

  • Select Information Management System
  • Select Feasibility of HIMS sync with Claims Application
  • Select Ambulance
  • Select Ambulance Type
  • Select Biomedical gases
  • Select Infection Control
  • Select CSSD
  • Select Method of sterilization
  • Select Demarcated Area
  • Select QC for sterlization
  • Select Patient safety
  • Select earthquake-building parameters
  • Select Fire Safety Drills
  • Select Linen & Laundry Services

Other Services

  • Select general cleanliness
  • Select housekeeping
  • Select parking space
  • Select waiting rooms
  • Select cafeteria

Medical Infrastructure check_circle

Bed Strength Details

  • Enter Valid Gen ward
  • Enter Valid Twin Sharing
  • Enter Valid Single AC
  • Enter Valid ICU
  • Enter Valid HDU
  • Enter Valid NICU
  • Enter Valid PICU
  • Enter Valid Dialysis
  • Enter Valid Daycare
  • Enter Valid Nurse to Patient Ratio
  • Enter Valid Nurse to patient ration in ICU
  • Enter Valid Doctor to patient ratio
  • Enter Valid doctor to patient ratio in icu

Operation theatres

  • Enter Valid Major
  • Enter Valid Minor
  • Enter Valid labour room
  • Enter Valid Specialized OT's
  • Enter Valid HDU
  • Enter Valid Cathlab
  • Enter Valid Orthopedics
  • Enter Valid Neurosurgery
  • Enter Valid Transplant
  • Enter Valid Others (Pls specify)

OT Zone

  • Select Preparation, Pre & Post-Operative, Scrub
  • Select Laminar Flow
  • Select HEPA filters installed in OT's
  • Select OT Technician
  • Select OT Nurse (Staffing per table)
  • Select List of equipment and Facilities in OT

Human Resource

  • Enter Valid Total Staff Strength
  • Enter Valid Total Doctors
  • Enter Valid Availability of Full Time Consultants (Append List)
  • Enter Valid Visiting Consultants (Append List)
  • Enter Valid Visiting Surgeons or Interventionists
  • Enter Valid RMO
  • Enter Valid Total Doctors available for ICU
  • Enter Valid Duty Medical Officer
  • Enter Valid P.G qualified doctors available for ICU
  • Enter Valid MBBS doctors for ICU taking all the shifts together
  • Enter Valid Total Nursing Staff
  • Enter Valid Nursing Staff (Qual) for ICU taking all the shifts together
  • Enter Valid Paramedical Staff
  • Enter Valid Technicians

Equipment

  • Choose correct file List of equipment and Facilities in ICU File is Uploaded. check_circle
  • Choose correct file List of equipment and Facilities in Labour room File is Uploaded. check_circle
  • Any Other facility

Quality and Performance Indicators check_circle

  • Enter Valid Total number of patients admitted during calendar year
  • Enter Valid Total number of surgeries performed
  • Enter Valid Bed Occupancy rate (Overall & for each room)
  • Select Average LOS
  • Enter Valid Total LSCS in F.Y
  • Select Re admission Count
  • Enter Valid Mortality rate
  • Enter Valid Average Admission Time
  • Enter Valid Average Discharge Time

License and Certifications

  • Select NABH
  • Choose correct file NABH File is Uploaded. check_circle
  • Select JCI
  • Choose correct file JCI File is Uploaded. check_circle
  • Select NABL
  • Choose correct file NABL File is Uploaded. check_circle
  • Select ISO
  • Choose correct file ISO File is Uploaded. check_circle
  • Select Bio Medical Waste Management
  • Choose correct file Bio Medical Waste Management File is Uploaded. check_circle
  • Select Pollution control
  • Choose correct file Pollution control File is Uploaded. check_circle
  • Select Fire NOC
  • Choose correct file Fire NOC File is Uploaded. check_circle
  • Select PC/PNDT
  • Choose correct file PC/PNDT File is Uploaded. check_circle
  • Select USG Certificate
  • Choose correct file USG Certificate (if in house) File is Uploaded. check_circle
  • Select MTP
  • Choose correct file MTP File is Uploaded. check_circle
  • Select NDPC
  • Choose correct file NDPC File is Uploaded. check_circle
  • Select Organ Transplant
  • Choose correct file Organ Transplant File is Uploaded. check_circle
  • Select AERB (Atomic Energy Regulatory Board) Certificate
  • Choose correct file AERB (Atomic Energy Regulatory Board) Certificate File is Uploaded. check_circle
  • Select Lift Commission Certificate
  • Choose correct file Lift Commission Certificate File is Uploaded. check_circle
  • Select Explosive License for O2 Tank
  • Choose correct file Explosive License for O2 Tank File is Uploaded. check_circle
  • Select Income Tax Exemption Certificate 17(ii)B
  • Choose correct file Income Tax Exemption Certificate 17(ii)B File is Uploaded. check_circle
  • Select MSME Certificate
  • Choose correct file MSME Certificate File is Uploaded. check_circle

Self Declaration check_circle


    I/We hereby declare that the particular given above are correct and Complete. If the transaction is delayed for reasons of any error, inaccuracy or mistake due to incompleteness or delay in providing above details, I/We would not hold Care Health Insurance.


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