Onboard Hospital — Claim Management System

Basic Hospital Information

Hospital Name *

Hospital Type *

Hospital Registration Number

NABH Accreditation

NABL Lab Accreditation

Add one or more branches. Mark one as the primary location.

Location 1Primary

Branch Label

Address Line 1

Address Line 2

City *

State *

PIN Code *

Primary Contact Person *

Designation

Phone Number *

Email Address *

Accounts / Billing Contact (optional)

Emergency Contact Number

Hospital IP Prefix / Format

Average Monthly Claim Volume

Departments Covered

Service Fee Percentage

Billing Model

Agreement Start Date

Agreement End Date

Payment Terms (Days)

General Hospital Agreement (Optional)Click to upload

Hospital Registration CertificateClick to upload

GST CertificateClick to upload

Bank Details DocumentClick to upload

NABH Certificate (optional)Click to upload

Add a signed agreement per panel. Only panels with valid agreements will be available while creating claims.

No panel agreements added yet. Click "Add Panel Agreement" to map a panel.

Create Hospital Login

Hospital Portal Access Email

Assign Relationship Manager