Nmhaacqsp1 Policy & Procedure For Admission and Registration of Patient & Non-Availability of Beds

NARAYAN MEMORIAL HOSPITAL Document No.
(A UNIT OF NARAYAN HEALTH SERVICES PVT. LTD.) NMH/AAC/QSP/1
POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

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PATIENT & NON-AVAILABILITY OF BEDS

NARAYAN MEMORIAL HOSPITAL

(A UNIT OF NARAYAN HEALTH SERVICES PVT. LTD.)
Behala Manton, 85, (Mail – 601), Diamond Harbour Road, Kolkata- 700034, West Bengal
Issue No: 01 Version No: 1

MANUAL
Issue Date: 22.01.2024 Revision Date: NA

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DOCUMENT SUMMARY
Policy for admission and registration of patient &
Document Title
non availability of beds
Document No. NMH/AAC/QSP/1
Current Version No. 1
Implementation Date 22.01.2024
Department Front Desk & Emergency
Document Storage Location Front Desk & Emergency & Quality Assurance
DOCUMENT DISTRIBUTION
Sl No. Name Designation Department
Consultant & Head – Emergency
1 Dr. Sudip Chakraborty Emergency
Medicine
2 Ms. Sheuli Choudhury OPD In-charge Operations
DOCUMENT REVISION HISTORY

Sl No. Version No. Date of Amendment Page No. Clause No. Amendment Details
NA NA NA NA NA NA
DOCUMENT AUTHOR(S)
Version No. Name Designation Signature Date
1 Ms. Sheuli Choudhury OPD In-charge 22.01.2024
DOCUMENT REVIEWER(S)
1 Ms. Pritha Sur Chief Administrator 15.11.2023
DOCUMENT APPROVER(S)
1 Ms. Pritha Sur Chief Administrator 15.11.2023
DOCUMENT ISSUE
Issue No. Name Designation Signature Date
1 Ms. Subhasree Ghosh Executive- Quality Assurance 22.01.2024

MANUAL

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TABLE OF CONTENT
Sl. No. TITLE Page No.

1 POLICIES AND PROCEDURES FOR REGISTERING AND ADMITTING PATIENTS 4
2 POLICY & PROCEDURE FOR ADMISSION AND INPATIENT BILLING 8
3 POLICY & PROCEDURE FOR NON-AVAILABILITY OF BEDS 13
4 POLICY & PROCEDURE FOR PRIORITISED PATIENT ACCORDING TO THE 14

CLINICAL NEED
5 LIST OF DOCUMENTS 15
6 REFERENCES 15
7 ABBREVIATION 16

MANUAL

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1. POLICIES AND PROCEDURES FOR REGISTERING AND ADMITTING PATIENTS
1. POLICY
The patient comes for OPD consultation; Investigation and Emergency Doctor Consultation (in
emergency department) are registered by getting a unique registration number.
2. PURPOSE
To standardize the process of registration of OPD patients and investigation billing.
3. SCOPE
All patients arriving in the hospital for OPD consultation with the Doctors and / or for investigations
(applicable for Ground Floor, 1st floor Reception).
4. RESPONSIBILITY
Front office staff, Emergency Medical Officer.
5. DISTRIBUTION
OPD, Admission & Investigation counter, Emergency.
6. PROCEDURE
6.1.Out Patient Appointment:

 Advance Booking for all OPD Consultation is done over phone or in person and the patient
register his/her name for a particular consultant in advance.
 In such cases, patient’s name, age, phone number are being recorded in the appointment register.
 In case the Consultant cancels the appointment, the patient is being informed over phone and the
next available appointment is being given in consonance with the Consultant and the patient.
6.2.Out Patient Registration:

 Whenever a patient approaches the Reception/ Information counter, we request the patient to
explain the purpose of his/ her visit.
MANUAL

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 Provide the necessary guidance to the patient about the facilities available, availability of the
consultants, charges etc in case of walk in patient
 If a patient is not aware of the doctor he would like to consult, he is guided to the emergency
doctor for recommendation of the right specialization.
 If the patient agrees to make a visit to the OPD Consultant explains the process to the patient.
 Check availability of the concerned Consultant by enquiring the Leave notice, issued by the
concerned authority.
 Enquire from the patient if he/ she has availed any services from Narayan Memorial Hospital/
registered earlier.
 In case patient has advanced booking he/ she reports directly to the 1st floor OPD counter.
 Obtain the requisite information from patient (e.g. Name, Age, Sex, Address, doctor he/ she
wants to visit etc) in Patient Registration Form and put the information in the computer by
invoking OPD registration menu.
 In case the patient is already registered with the hospital earlier the patient’s registration number
retrieves the patient’s details from the data base.
 Collect the requisite Consultation fees and generate 2 copies of Invoice cum Money receipt.
 Hand over the money receipt to the patient.
 Pass on the 2nd copy to the concerned OPD Sister.
 After the consultation with the doctor, his/her prescription is read by the OPD reception /OPD
In-charge and he/she is guided accordingly.
 Investigation- He/ She is informed about the rates of the investigations, duration of the same.
All kinds of discounts if applicable are informed to him/her. The investigation booking is
guided by the OPD staff in coordination with the respective diagnostic departments.
 Follow up- If the patient is advised a follow up visit; he/she is given an appointment according
to his/her convenience.
 Admission - In case a patient is advised admission, he/she is guided to the Admission counter.
6.3.Investigation Billing:
 When the patient approaches to the front office for an investigation request, the patient needs to
produce the Doctors prescription.
 Study the same minutely and inform the patient about the availability of the services, the related
cost, the available time slot and the time of availability of the diagnostic reports.
 Any investigation which needs prior appointment is being coordinated with the concerned
department by the front office executives.

MANUAL

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 For all cases inform / educate the patient / NOK about the do’s & don’t, and any other
prerequisites for the investigation in coordination with the concern diagnostic departments.(e.g.
The patient should be advised to be on empty stomach for a Fasting sugar blood test)
 In case the patient wants to have an “Estimate”, generate an Estimate by operating the OPD
Management system module and hand over the same to the patient / NOK.
 If the Patient/NOK had deposited an advance amount on the day of booking, generate OPD
advance slip from the system and hand over the same to the patient/NOK.
 If the patient comes to the investigation counter with prior booking, front office executive ensure
the preparation of the said test (if required) prior to generate the bill and collect the requisite
charges.
 Generate 1 copy requisition for the respective diagnostic department and 1 copy of “Invoice cum
Money Receipt” after receiving the full payment. Original of the same is being handed over to
the patient / NOK and the Duplicate copy is preserved in the system.
 Request the patient to approach and wait in the lobby/ waiting hall of the concerned Diagnostic
department.
 Consult with the concerned departmental staff in case of any sort of confusion regarding the
preparation / timings/ charges for the investigations etc.
 To perform any investigation, prescription of a Doctor/ Clinician is Mandatory. Routine blood
test is accepted on self request.
6.4.Dialysis Billing:
 Billing is initiated as per booking list given by the dialysis department.
 Generate two invoices cum money receipts.
 In case of corporate patient the money receipt needs to be signed by the patient’s NOK and is to
be preserved in the department along with the credit letter and to be submitted to the corporate
billing at the end of every month.
 In case of TPA patient an authorization letter comes from the TPA in-charge to the front office
and the billing is done according to the approval letter.
 In case of patient does not have booking for the same day the patient is catered and treated as an
emergency patient.
6.5.Handling Corporate Clients:

 In such cases patients carry referral letter of Narayan Memorial Hospital approved corporate
clients, register the patient for consultation / investigation by operating the computer module and
against the name of the corporate house.

MANUAL

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 Do not ask for any payment for such cases.

 Generate 1 copy requisition from the system and forward the same to the concerned department.
 Generate 2 copies of “Invoice cum Money Receipt”. One copy of the same has to be signed by
the patient and preserved along with the referral letter. One duplicate copy is given to the
patient/NOK.
 Send the Referral letters (Issued by the corporate) along with the invoice cum money receipt to
the corporate billing department on particular patient’s approval basis.
 Sometimes credit facility is given to corporate patients on the basis of previously submitted
referral letter or instructions by the BDCR (Billing department corporate relation) dept.
 For any confusion, coordinate with the BDCR (Billing department corporate relation) dept.
6.6.Health Check-up:
 In case of corporate Health check-up the person carry credit letter/Offer letter (in case of pre-
employment health check-up) of the empanelled corporate and 2 copies of invoice cum money
receipt are generated as per defined package in favour of the respective corporate client.
 The invoices are submitted to the respective department by the person in coordination with the
front office staffs.
 A copy of the money receipt is kept along with the credit letter and submitted to the corporate
billing department on monthly basis.
 In case of cash patient, the hospital offers different packages through out the year and the invoice
cum money receipt is generated accordingly.
6.7.Payments by Credit Cards:

 For credit card payments, cards accepted only after approved by the Finance department of
Narayan Memorial Hospital.
 Generate one merchant copy and one customer copy by operating the swipe machine and entering
the due amount.
 The Card holder’s signature is obtained on the merchant copy and compare with the same as
appears on the card.
 If both the signature tallies, file the merchant copy in the respective file and return the customer
copy to the customer.
6.8.Handing over the Cash:

 At the specified timings tally the cash collected up to that hour with the Scroll generated from
the computer and handed over to the finance department.

MANUAL

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6.9.Cancelation and modification of Bill:

 In case of cancellation of diagnostic test or doctor’s visit, signatures are taken against that invoice
by the departmental head/ concern doctor and the billing personnel.
 The same invoice comes to the OPD In-charge for the final cancellation in the system.
 In case a bill needs modification, a valid explanation has to be given by the billing personnel and
the final modification is done by the OPD In-charge in the system.
2. POLICY & PROCEDURE FOR ADMISSION AND INPATIENT BILLING
1. POLICY
All patients are admitted in the hospital as per advice of Emergency Medical Officer (EMO) and
are registered by getting a unique registration number. In case of next admission for the same patient
only IP No. gets changed, however the registration no. remains same i.e., UHID No.
2. PURPOSE
To standardize the process of admission of patients as In-patient.
3. SCOPE
All patients are admitted in the hospital as In-patient.
4. RESPONSIBILITIES
Front office staff, Emergency Medical Officer.
5. DISTRIBUTION
Admission counter & Emergency

MANUAL

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6. PROCEDURE:
6.1.Admission:
 All Patients comes for admission (including Day Care Admission) are guided to the emergency
department and admitted as per advice of Emergency Medical Officer (EMO).The emergency
assessment is documented in the Emergency Initial Assessment Form & then Advice for
Emergency Admission.
 According to the advice of EMO, the patients are admitted in ICU or General Ward or HDU and
the bed no. is allotted by the EMO in coordination with the admission personnel.
 The patient/ NOK are counseled by the financial counselor.
 After completing emergency assessment and financial counseling, the patient/ patient’s NOK is
guided to the admission counter. The admission personnel ensure that the patient/ patient’s NOK
fills up the admission requisition and Admission Form.
 The relevant provision of the Consent is explained in an understandable manner, if the patient/
NOK are not in a position to read / understand the contents of the Consent form.
 In case of illiterate patient/ NOK thumb impression is obtained and witnessed on the Admission
Consent form and admission requisition form.
 In the Admission requisition form, the type of admission (Hospital/ Corporate/ TPA/ Private
case) is mentioned.
 For corporate patients, different categories of beds in general ward/ special wards are allotted on
the basis of entitlement or availability.
 The admission executive simultaneously calls up the respective floor manager to ensure that the
bed is ready before sending the patients to the floor.
 The written admission requisition form is entered in the software. Each patient gets a registration
number (i.e., UHID) and an Admission Number.
 The Admission No. is the unique identification for each patient staying in the hospital. All further
proceedings are carried on under this UHID.
 A Patient identification band is given from the admission counter for tying it on the patient wrist
on the floor by the sister; it contents Name of the patient, Reg. No, Age, Sex and name of the
Primary Consultant.
 The admission Booklet along with other valid documents goes to the respective Floor Manager
in the nursing station.

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6.2.Types of Admission
 Cash Admission: When the patient’s relatives agree to pay by cash, credit card or demand draft
- it is treated as a cash patient. The patient/ patient’s NOK is explained about the minimum
deposit for different bed categories, which is mandatory for a cash admission. If the patient comes
as emergency, he is admitted with nominal deposit amount and a declaration is given by the
patients /NOK to deposit the residual amount at the earliest. For package cases, total package
amount is collected before the package gets implemented.
 Insurance Admission: For all TPA patients, before admission, or in case of emergency admission
within 24 hours of admission the ID card / Policy papers is deposited by the patient/ patient’s
NOK and declaration of payment in case of cashless denial is being filled up by patient or next
of kin.
 Corporate Admission: When a patient is referred by our empanelled list of corporate, the patient
has to carry a referral letter from the concerned corporate stating the bed category and the credit
terms and conditions. In case a patient comes without a letter for an emergency unplanned
admission; he / she can be admitted with the company’s identity card. The Marketing department
is informed verbally. The entry in the software is made in accordance to the corporate name. The
Referral / Credit letters goes to the indoor billing and a photocopy of the same is kept in the
patient file.
 Staff Admission: The staff and their dependent are offered a subsidized rate as decided by the
management. An Identity proof is attached to the admission form. The employee number is
mandatory for further queries.
 Package Admission: When the patient is getting admitted under a package, the package details
are explained to the patient’s NOK by the financial counselor and the same is documented.
 MLC Admission: Medico Legal Case Report is filled up by EMO on duty/Doctor in-charge of
the case. Two copies of the same are made, both the copies are sent to the local police station out
of which the received copy with stamp is being preserved in the patient’s file for further
proceedings.

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 Emergency patient admission: In emergency cases, patients are transferred to the Ward/ICU
immediately after EMO’s advice and after that the patient’s NOK is guided to the counseling cell
and admission counter to complete all formalities.
 Unidentified patient admission: For unidentified patients, if the patient is not carrying and
identification details and also not accompanied by any person who knows the patient personally
then the admission is done by naming the patient as “Unknown”. Information given to the local
police station and the patient is sent to the respective department for further treatment.
 VIP admission: In case of VIP admission, if there is prior information about the admission then
bed is already kept for allocation according to the information. But in case of sudden arrival, the
patient is taken to the bed by the patient service department and front office staff collects the
details of the patient from the cabin.
6.3.Patient/ NOK Counseling
 Patient/ Patient’s NOK (except corporate) is informed about the charges of the bed / package cost
and expected length of stay by the financial counselor at the time of admission and documented
in financial counseling form in the admission booklet.
 The clinical counseling is done by allotted RMO in coordination with the primary consultant and
documented in clinical counseling form in the admission booklet.
6.4.Obtaining Advance amount from patients:
 In case of cash patients, the advance amount is to be accepted as ‘Advance Money Receipt’.
 Patient’s NOKs are to be requested to produce this bill at the time of discharge of their patient.
 In case of package cases, the name and amount of the package is to be mentioned clearly in the
consent form.
 In case of corporate patients, package amount is not to be mentioned.
6.5.Visiting Card:
 Visiting cards are to be issued at the time of admission for all patients.
 For the patient staying in Single Room or above one extra 24 hours stay pass is given during
admission.

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 In case of loss of visiting pass, patient’s NOK is requested to make an application to the Hospital
administration to issue duplicate pass.
6.6.Collection of Payments:
 For all cash patients, patient’s NOK are to be informed about their bill amount through interim
bill regularly by the concerned floor manager during the visiting hours.
 All payments of the admitted (indoor) patients are to be collected through computerized system
 The total cash / cheque collected are deposited to the finance dept by the front office personnel
with in a stipulated time.
 Master / Visa / any other approved credit/debit cards are also to be accepted for payments.
 The billing personnel to ensure that all the charge slips are signed by the Card holder and the
same is in line with the one appear on the card.
 Original copy of the charge slips are to be retained and deposited to the finance dept along with
the scroll and the duplicate is to be returned to be customer.
6.7.Bed Transfer Procedures:
A patient stay in the hospital may not necessarily be in the same bed. There is a transfer protocol,
which is as follows:
 A bed transfer requisition form is filled up by the relatives at the admission counter.
 The desired bed is mentioned on the transfer requisition.
 The bed allotment is done by front office executives according to the transfer requisition.
 The front office informs the ward from where the patient is getting transferred and also to the
ward where the patient will be transferred.
 After completion of the process the requisition is kept in the patient file and the copy remains
with admission office.
6.8.Bed Up- gradation Procedures:
When a patient comes for admission without prior booking and the required bed is not available,
the protocol is as follows:
 The next higher category bed is arranged.
 The Ward/ Floor manager is given information about the up-graded admission.

MANUAL

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 The floor manager & the admission personnel jointly take the responsibility of getting the patient
transferred to the desired bed in coordination with the nursing staff.
 The above steps are carried out after briefing and taking consent from the appropriate authority.
3. POLICY & PROCEDURE FOR NON-AVAILABILITY OF BEDS:
1. POLICY
 At Narayan Memorial Hospital, in case of non availability of general bed the patient is kept in
observation beds in emergency till the desired bed is available and in the mean time treatment is
started.
 In a situation when a patient needs critical care admission but no such bed is available then the
patient is attended by the on duty EMO & then advised to shift to the nearest hospital, which can
provide the necessary care & treatment to the patient.
2. PURPOSE:
To provide uninterrupted patient (both critical and non-critical) care.
3. SCOPE:
The patient admitted in the hospital /transferred from the hospital in case of non-availability of bed.
4. RESPONSIBILITIES:
Front office staff, Emergency Medical Officer, Nursing staff, Medical admin.
5. DISTRIBUTION:
Hospital wide.
6. PROCEDURE:
6.1.ICU Beds:
 When all critical care beds in hospital are occupied, a notice is displayed on the main gate
(NO ICU BEDS AVAILABLE).
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 If any emergency patient comes then initial management is given to stabilize the patient and
made fit to transfer. After confirming the bed availability in other hospital with the
consultation and co-operation of patient’s NOK, the patient is sent through an ambulance,
accompanied the following documents- provisional diagnosis, details of treatment given,
present condition of the patient.
6.2.Normal Beds:
 There are several categories of beds – general bed, twin sharing, single room, suits, etc. In
case of non -availability of general beds the patients are put in the higher category beds (e.g.
twin sharing, single room and suits).
 In certain cases when the family members of patient is reluctant to go into the higher
category, the patient is kept in the higher category bed but charged as per patient’s original
category by the permission of the concerned authority and shifted back to the desired
category as soon as the bed is available.
4. POLICY & PROCEDURE FOR PRIORITISED PATIENT ACCORDING TO THE CLINICAL

NEED
1. POLICY
At Narayan Memorial Hospital, patients with clinical problem which need an earlier response are
identified and prioritised in all care settings.
2. PURPOSE
To provide immediate healthcare service to the prior patient.
3. SCOPE:
Clinical care is given to all prior patients.
4. RESPONSIBILITIES
Front office staff, Emergency Medical Officer, Nursing staff.

MANUAL

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5. DISTRIBUTION
Hospital wide.
6. PROCEDURE:
 If patient with clinical problem which need an earlier response are identified in the queue.
 The prior patient is attended by the doctor immediately.
 If the authorized consultant is not available in the hospital then the patient will be attended by
the doctor available in the hospital immediately.
5. LIST OF DOCUMENTS
FORMS
SL NO. FORM NAME FORM ID
1 Patient Registration Form NMH/AAC/FM/Pt_Reg/Ver.1/1023
2 Emergency Initial Assessment Form NMH/COP/FM/ER_Ini_Ass/Ver.1/1023
3 Advice For Emergency Admission NMH/COP/FM/Adv_Emer_Adm/Ver.1/1023
4 Admission Form NMH/AAC/FM/Adm/Ver.1/0923
REGISTERS
SL NO. REGISTER NAME REGISTER ID
NA NA NA
FILES
SL NO. FILE NAME FILE ID
NA NA NA
6. REFERENCES
National Accreditation Board For Hospitals & Healthcare Providers (5th edition)

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7. ABBREVIATION
1. OPD- Out Patient Department

2. NOK- Next Of Kin
3. TPA- Third Party Administrator
4. BDCR- Billing Department Corporate Relation
5. EMO- Emergency Medical Officer
6. UHID- Unique Hospital Identification Number
7. IP- In Patient
8. ICU- Intensive Care Unit
9. HDU- High Dependency Unit
10. ID- Identification
11. MLC- Medico Legal Cases
12. VIP- Very Important Person
13. RMO- Register Medical Officer

MANUAL

Nmhaacqsp1 Policy & Procedure For Admission and Registration of Patient & Non-Availability of Beds

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NARAYAN MEMORIAL HOSPITAL Document No.

(A UNIT OF NARAYAN HEALTH SERVICES PVT. LTD.) NMH/AAC/QSP/1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

NARAYAN MEMORIAL HOSPITAL

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

DOCUMENT REVISION HISTORY

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

Sl. No. TITLE Page No.

2 POLICY & PROCEDURE FOR ADMISSION AND INPATIENT BILLING 8

3 POLICY & PROCEDURE FOR NON-AVAILABILITY OF BEDS 13

4 POLICY & PROCEDURE FOR PRIORITISED PATIENT ACCORDING TO THE 14

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

1. POLICIES AND PROCEDURES FOR REGISTERING AND ADMITTING PATIENTS

To standardize the process of registration of OPD patients and investigation billing.

Front office staff, Emergency Medical Officer.

OPD, Admission & Investigation counter, Emergency.

6.1.Out Patient Appointment:

6.2.Out Patient Registration:

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

6.5.Handling Corporate Clients:

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

 Do not ask for any payment for such cases.

6.7.Payments by Credit Cards:

6.8.Handing over the Cash:

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

6.9.Cancelation and modification of Bill:

2. POLICY & PROCEDURE FOR ADMISSION AND INPATIENT BILLING

To standardize the process of admission of patients as In-patient.

All patients are admitted in the hospital as In-patient.

Front office staff, Emergency Medical Officer.

Admission counter & Emergency

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

6.3.Patient/ NOK Counseling

6.4.Obtaining Advance amount from patients:

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

6.7.Bed Transfer Procedures:

6.8.Bed Up- gradation Procedures:

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

3. POLICY & PROCEDURE FOR NON-AVAILABILITY OF BEDS:

To provide uninterrupted patient (both critical and non-critical) care.

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

4. POLICY & PROCEDURE FOR PRIORITISED PATIENT ACCORDING TO THE CLINICAL

To provide immediate healthcare service to the prior patient.

Clinical care is given to all prior patients.

Front office staff, Emergency Medical Officer, Nursing staff.

Issue No: 01 Version No: 1

POLICY & PROCEDURE FOR ADMISSION AND REGISTRATION OF

Issue No: 01 Version No: 1