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OFFICE OF THE MEDICAL SUPERINTENDENT E.S.I.C. MODEL HOSPITAL, ROURKELA 4 Email : Rourkela. Or Eric.in×Rourkela Eric.in : pH. 06616502125×6536027 : Fax 06612482096 To DOCUMENT COST RS. 500/ (NonRefundable)
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How to fill out esic empanelment application form 2023
How to fill out ESIC empanelment application form:
01
First, download the ESIC empanelment application form from the official website of the Employees' State Insurance Corporation (ESIC).
02
Fill in your personal details accurately, including your name, address, contact information, and other relevant information as per the instructions provided.
03
Provide the necessary details about your organization, such as the name, address, type of organization, registration details, and any other required information.
04
Attach the necessary documents as mentioned in the application form, such as proof of registration, proof of address, photocopies of identity cards, and other supporting documents.
05
Fill in the details about the services or facilities provided by your organization, including the specific healthcare services or treatments offered, the infrastructure available, and any other relevant details.
06
Provide information about the staff members or professionals associated with your organization, including their qualifications, experience, and any other required details.
07
Mention any tie-ups or collaborations your organization has with other healthcare providers or insurance agencies, if applicable.
08
Review the completed application form to ensure all the necessary fields are filled correctly and all the required documents are attached.
09
Sign the application form and make sure that any other authorized signatory also signs the form, if required.
10
Submit the filled-out application form along with the necessary documents to the designated ESIC office or as instructed in the application form.
Who needs ESIC empanelment application form:
01
Healthcare organizations or institutions wishing to become empaneled with the Employees' State Insurance Corporation (ESIC) for providing medical services to ESIC beneficiaries.
02
Private hospitals, clinics, diagnostic centers, nursing homes, and other healthcare facilities that meet the eligibility criteria specified by ESIC.
03
Healthcare professionals, such as doctors, specialists, and paramedical staff, who wish to be associated with ESIC empaneled healthcare organizations and provide their services to ESIC beneficiaries.
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What is esi application?
The ESI application refers to the online form that employers must submit to register their employees under the Employee State Insurance (ESI) scheme, a social security program for providing medical and financial benefits to employees and their families.
Who is required to file esi application?
Every employer who falls under the provisions of the ESI Act and is running an establishment with a specified number of employees is required to file the ESI application for their employees.
How to fill out esi application?
To fill out the ESI application, employers must gather required employee details, such as personal identification and employment information, and complete the online form on the ESI portal, ensuring all information is accurate and up to date.
What is the purpose of esi application?
The purpose of the ESI application is to enroll eligible employees in the Employee State Insurance scheme, which provides them with medical benefits, maternity benefits, and other financial support during emergencies.
What information must be reported on esi application?
The ESI application must report information such as the employer's details, employee details (like name, age, gender, identification number), the establishment’s information, and details pertaining to wages and employment status.
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