Employees’ State Insurance Corporation (ESIC) has issued a new official circular concerning revised guidelines on patient transfers. This update is issued under File No.: U-16/30/649/2023-SST dated 23.06.2026 for making patient referrals transparent, uniform and quick across all ESI hospitals and medical colleges having laid down a standardized process.

Key highlights

A clear real time photo of the patient to be taken and uploaded directly into P1 referral form.
The referral must be started by the treating doctor, confirmed by the department head and sanctioned by the hospital head.
Staff must not share their system user IDs and passwords under any circumstances for security reasons.
The referral form should be signed by the Dean or Medical Superintendent of the hospital to keep track of the deficiencies of the hospital and manage the financial sanctions.
The current or provisional diagnosis of the patient must be clearly stated on each referral form following consultation with the head of the department.
Doctors must confirm the patient’s identity to avoid fraud and verify their active ESIC insurance eligibility before referral.
The physical form must be signed or thumb printed by the patient or by the patient’s accompanying attendant.
Urgency (Emergency or Routine), level (Secondary or Tertiary) and type of hospital are important classification aspects of referrals.
There must be good clinical reasons for a patient to need an open billing package or a longer hospital stay,” doctors said.
The online P1 referral form shall be developed and generated in-house and not outsourced.
All committee members and approving authorities must sign with their full names and not with short initials.
Instead of saying “no ICU beds available,” doctors have to choose the exact, real reason for transfer from a list in the system.
The referring doctor is responsible for reviewing and saving the complete and accurate form in the system.
Routine referrals from smaller dispensaries must get digital signatures from their nearest designated hub hospital.
Referrals will be processed on the same day using fixed daily time slots at 11:00 AM, 1:00 PM, and 4:00 PM.
Patients' waiting time should be minimized and grievances reduced by having the staff assigned to generate Claim IDs work fixed hours.
ESIC officials will carry out unannounced checks to see referral trends and identify any suspicious or abnormal practices.
ESIS hospitals, dispensaries to accord top priority to refer patients to central ESIC hospitals, medical colleges
Attach all medical reports, tests results and insurance certificates to referral form.

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Implementation of New SOP for P1 Referral Process Across All ESI Institutions