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.,. E.S.I.C cfi~fll.ft iftJrr i;rm:r (-'JPJ vcr ~. an«r EMPLOYEES' STATE INSURANCE CORPORATION (Ministry of Labour & Employment, Govt. of India) 6~~W. ~l~l~a/~ cfil.zfi<>14 /Regional Office tlB~tl Q'ii'g, ggt]eJ, w)'ii'6gfi]£l-751022 31Cfo'f', ~. ~cR"-751022 Panchdeep Bhawan, Janpath, Bhubaneswar-751022 Phone: 0674-2546380, Fax: 0674-2546381 Email: [email protected] . in, Web: www. esic.nic.in No. 44-R-17/14/20i 9(Med)SST-Vol I Date: 29.10.2021 To, All SST Tie Up Hospitals Sub: Empanelment of Hospitals for providing Super Speciality 'Ireatment to the ESI Benefi- ciaries - reg. Madam/Sir, With reference to the above mentioned subject, the undersigned on behalf of ESI Corporation is glad to extend a warm welcome with best wishes to all the Tie Up Hospitals mentioned below who have expressed their willingness to provide SST services to our beneficiaries. SI. Name of the Hospital Departments (Super Specialist) Period of As reement No. considered From To I. Hi-Tech Medical Cardiology & CTVS, Neurology & 01.11.2021 31.10.2023 College & Hospital, Neuro Surgery, Paediatric Surgery, Bhubaneswar Nephrology & Urology, Gastroenterology & G.I. Surgery, Endocrinology & Endocrine Surgery, Burn & Plastic Surgery and Reconstruction Surgerv 2. Utkal Health Care _Cardiology & CTVS, Neurology & 01.11.2021 31.10.2023 Pvt. Ltd., Neuro Surgery, Paediatric Surgery, Bhubaneswar Oncology & Onco Surgery, Nephrology & yrology, Gastroenterology & G.I. Surgery, Burn & Plastic Surgery and Reconstruction Surgerv' 3. SUM Ultimate, Cardiology & CTVS, Neurology & 01.11.2021 31.10.2023 Bhubaneswar Neuro Surgery, Paediatric Surgery, Oncology & Onco . Surgery, . Nephrology & Urology, Gastroenterology & G.I. Surgery, Endocrinology & Endocrine Surgery, Burn & Plastic Surgery and Reconstruction Surllerv 4. Kalinlla Institute of CardiolollV & CTVS. NeurololIV & 01.11.2021 31.10.2023

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• .,. E.S.I.C

cfi~fll.ft iftJrr i;rm:r (-'JPJ vcr ~. an«r

EMPLOYEES' STATE INSURANCE CORPORATION

(Ministry of Labour & Employment, Govt. of India)

6~~W. ~l~l~a/~ cfil.zfi<>14 /Regional Office tlB~tl Q'ii'g, ggt]eJ, w)'ii'6gfi]£l-751022

31Cfo'f', ~. ~cR"-751022 Panchdeep Bhawan, Janpath, Bhubaneswar-751022 Phone: 0674-2546380, Fax: 0674-2546381 Email: [email protected], Web: www.esic.nic.in

No. 44-R-17/14/20i 9(Med)SST-Vol I Date: 29.10.2021

To, All SST Tie Up Hospitals

Sub: Empanelment of Hospitals for providing Super Speciality 'Ireatment to the ESI Benefi-ciaries - reg.

Madam/Sir,

With reference to the above mentioned subject, the undersigned on behalf of ESI Corporation is glad to extend a warm welcome with best wishes to all the Tie Up Hospitals mentioned below who have expressed their willingness to provide SST services to our beneficiaries.

SI. Name of the Hospital Departments (Super Specialist) Period of As reement

No. considered From To

I. Hi-Tech Medical Cardiology & CTVS, Neurology & 01.11.2021 31.10.2023

College & Hospital, Neuro Surgery, Paediatric Surgery, Bhubaneswar Nephrology & Urology,

Gastroenterology & G.I. Surgery, Endocrinology & Endocrine Surgery, Burn & Plastic Surgery and Reconstruction Surgerv

2. Utkal Health Care _Cardiology & CTVS, Neurology & 01.11.2021 31.10.2023

Pvt. Ltd., Neuro Surgery, Paediatric Surgery, Bhubaneswar Oncology & Onco Surgery,

Nephrology & yrology, Gastroenterology & G.I. Surgery, Burn & Plastic Surgery and Reconstruction Surgerv'

3. SUM Ultimate, Cardiology & CTVS, Neurology & 01.11.2021 31.10.2023

Bhubaneswar Neuro Surgery, Paediatric Surgery, Oncology & Onco . Surgery,

. Nephrology & Urology, Gastroenterology & G.I. Surgery, Endocrinology & Endocrine Surgery, Burn & Plastic Surgery and Reconstruction Surllerv

4. Kalinlla Institute of CardiolollV & CTVS. NeurololIV & 01.11.2021 31.10.2023

-

Medical Sciences Neuro Surgery, Paediatric Surgery, \ t

& Onco Surgery, (KIMS), Oncology ' Bhubaneswar . Nephrology & Urology, I'

Gastroenterology & G.I. Surgery,

7

Endocrinology 5. Sparsh Hospital, Neurology & Neuro Surgery, 01.11.2021 31.10.2023

Bhuban:eswar Oncology & Onco Surgery, Nephrology, Gastroenterology & G.I. Surgery,

6. IMS & SUM Cardiology & CTVS, Neurology & 01.11.2021 31.10.2023 Hospital, Neuro Surgery, Paediatric Surgery, Bhubaneswar Onco Surgery, Nephrology, Urology,

Gastroenterology & G.I. Surgery, I

Endocrinology 7. Vivekananda • Neurology & Neuro Surgery, Onco 01.11.2021 31.10.2023

Hospital, Surgery, .Burn & Plastic Surgery and Bhubaneswar Reconstruction Surgery

8. CARE Hospital, Cardiology & CTVS, Nephrology 01.11.2021 31.10.2023 Bhubaneswar

9. Apollo Hospital, Cardiology, CTVS, Oncology & Onco 01.11.2021 31.10.2023 Bhubaneswar Surgery

10. AMRI Hospital, Cardiology & CTVS, Nephrology & 01.11.2021 31.10.2023 Bhubaneswar Urology

11. Shanti Memorial Nephrology & Urology, 01.11.2021 31.10.2023 Hospital, Cuttack Gastroenterology & G.I. Surgery

12. Ashwini Hospital, Cardiology & CTVS, Neurology & 01.11.2021 31.10.2023 Cuttack Neuro Surgery, Nephrology &

Urology, Gastroenterology & G.I. Surgery, Burn & Plastic Surgery and Reconstruction Surgery

13. Ashwini Trauma Cardiology & CTVS, Neurology & 01.11.2021 31.10.2023 Centre Neuro Surgery, Paediatric Surgery,

Nephrology & Urology, Gastroenterology & G.I. Surgery, Burn & Plastic Surgery and Reconstruction Surgery '

14. SUN Hospital, Neuro Surgery, G.I. Surgery, 01.11.2021 31.10.2023 Cuttack

15. Jayprakash Hospital, Cardiology & CTVS, Neuro Surgery, 01.11.2021 31.10.2023 Rourkela Urology -

16. Rajsthan Seva DialY,sis 01.11.2021 31.10.2023 Sadan, Rourkela

17. Vikash Hospital, Cardiology, Neurology &. Neuro 01.11.2021 31.10.2023 Bargarh Surgery, Onco Surgery, Nephrology &

Urology 18. Medica TS Hospital, G.I. Surgery, Burn & Plastic ,Surgery 01.11.2021 31.10.2023

Jajpur Road and Reconstruction Surgery and Dialysis .

We are delighted to h . immensely beneficial/ ful ave you 1-? _o~ network of tie-up hospitals and hope it will be use to our benefiaar1es.

C ~e ti(. e-up is applicable for ESI beneficiaries including employees and pensioners of ESI

orporation ESIC) along with th • d d . . . . bill . err epen ant family members. The treatment and mvesttgauon d s case of ~bove mentioned employees and pensioners of ESI Corporation along with their

Behpebn ant family members will be accepted directly by the Regional Office, ESI Corporation,

u aneswar for payment.

. !h~ empanelled centre will provide treatment in General Bed only to the referred ESI Benefiaanes. In case of Staffs, pensioners and their dependent family members who are entitled for treatment from ESIC, the treatment may be provided as per their entitlement.

· . ·, It is to intimate clearly to all the concerned that as per Hqrs. Office directions the following will be treated as Super Speciality Procedure/Investigation.

1. Cardiology & CTVS 2. Neurology & Neuro Surgery 3. Paediatric Surgery 4. Oncology & Onco Surgery 5. Nephrology & Urology 6. Gastroenterology & G .I. Surgery 7. Endocrinology & Endocrine Surgery 8. Burn & Plastic Surgery and Reconstruction Surgery 9. Any treatment rendered to the patient at a tertiary centre/Super Speciality Hospital by a Super Specialist.

It is to intimate clearly that the ESI Hospitals/authorised Dispensaries will refer only the Super Speciality cases which come under the scope of the above mentioned Hqrs. Office letter along with clear instruction regarding the procedure to be performed over the patient at the empanelled HosP,ital/Centre. No referral is to be made giving vague diagnosis i.e. further m~a~ement/needful/further treatment etc. The TUH will accept the cases only on satisfaction of both the, a,bov_e Fonditions.

In case of any additional procedure/treatment to be performed by the empanelled hospital prior approval from the referring hospital is absolutely necessary. In case of any deviation from the above, the RO, ESIC will not take any responsibility regarding settlement of bills for such referral.

Further the terms and conditions of processing of bills by the Bill Processing Agency (BPA) and agreed upon mutually with ESIC shall be binding on the TUH.

In case the empanelled hospitals are interested to provide any treatment beyond above Specialities for which they have been tied up, they should finalize the same as per negotiation/agreement to be made with them and ESI Scheme, Govt. of Odisha.

Accordingly, the TUHs are requested to start treating/providing SST to referred patients by ESIS/ESIC institution w.e.f. !51 November, 2021 and arrange for signing of the agreement for the said purpose. The terms .and conditions of the EOI No. 44-R-17/14/2019(Med)SST-Vol I dated 06.08.2021, Corrigendum No. 44-R-17/14/2019(Med)SST-Vol I dated 06.08.2021 and 09.08.2021 will be the basis of signing the agreement.

Copy for information to:

iUl'S faithfully,

~a·V\ Dr.L ~ shra State Medical Officer

1. 1. The Principal Secretary, Labour & ESI Department, Govt. of Odisha, Bhubaneswar. 2. The Director ESI Scheme, Odisha with the request to intimate the ESI Hospitals & Dispensaries accordingly. 3. The Medical Commissioner, ESI Corporation, CIG Marg, New Delhi - 02. 4. The Medical Superintendent, ESIC Model Hospital, Rourkela. 5. The Superintendent, ESI Hospital ........ . .............. . .. 6. The IMO lie., ESI Dispensary, ........................ .. 7. The Branch Manager, Branch Office, ESI Corporation, Odisha. 8. IT Manager, ESIC, RO, Bhubaneswar with a request to upload this letter on website. 9; All the Tie Up Hospitals. 10. Concerned File.