NABH
NABH (National Accreditation Board for Hospitals & Healthcare Providers) certification is not issued to insurance companies. It is granted to Healthcare Organizations (HCOs) such as hospitals, laboratories, clinics, and wellness centers.
However, NABH accreditation plays a critical indirect role in insurance empanelment, as most insurance companies, Third Party Administrators (TPAs), and government health schemes mandate NABH certification for hospitals to be included in their provider networks for cashless and reimbursement claims.
NABH certification serves as recognized proof of quality, patient safety, and standardized healthcare delivery, making it a key differentiator for healthcare providers.
How NABH Certification Works (For Hospitals / HCOs)
Application
- Hospitals and HCOs apply online through the NABH portal for both Entry and Final level.
Implementation of Standards
- Organizations implement applicable NABH standards such as:
– Hospitals (HCO)
– Small Healthcare Organizations (SHCO)
– Digital Health & Wellness standards
- Focus areas include patient safety, infection control, clinical governance, and documentation
Assessment
- Desktop and onsite assessments are conducted by NABH assessors
Compliance & Closure
- Any Non-Conformities (NCs) identified during assessment must be addressed
- Corrective and Preventive Actions (CAPA) are submitted for review
Certification
- On successful compliance, NABH grants accreditation for a defined cycle
- Periodic surveillance assessments ensure continued compliance
In essence, insurance companies leverage NABH certification as a quality filter to select reliable healthcare partners, streamlining claims and ensuring better patient care.
Why NABH Matters for Insurance Empanelment
Empanelment with Insurers
- NABH accreditation improves eligibility for empanelment with:
– Insurance companies
– TPAs
– Corporate health schemes
– Government-funded programs
Standard of Care
- Ensures uniform, evidence-based clinical and safety standards
- Gives insurers confidence in quality outcomes and ethical practices
Trust & Credibility
- Builds trust among patients, insurers, and corporate clients
- Patients prefer NABH-accredited hospitals due to safety and transparency
Summary
While insurance companies themselves are not NABH-certified, they rely on NABH accreditation as a quality benchmark for selecting reliable healthcare partners.
For hospitals and HCOs, NABH certification enhances insurance empanelment opportunities, improves access to cashless treatments, and strengthens market credibility.