Health service providers accredited under the National Health Insurance Scheme [NHIS] to offer various forms of health care to clients of the scheme have been advised to spend time to diligently peruse claims vetting reports issued by the scheme so as not to repeat mistakes that lead to deductions in claims.
Bongo District Manager of the NHIS, Mr Mahamadu Seidu Akugri who gave the advice at the scheme’s review meeting with service providers held in Bongo, added that the situation where authorities of the facility providers often place all their concentration and focus on the claims cash and ignore vital information in the vetting reports such as reasons for particular deductions by the NHIS will only go back to repeat errors or mistakes in their claims preparations that continues to lead to cuts in claims submitted.
Mr Akugri also decried the untimely submission of claims by providers noting that, such undue delays only draws back the processes put in place to ensure smooth and prompt payments of claims. He disclosed that some of the providers across the Bongo District were yet to submit their claims to his office dating as far back as July, 2015.
He commended the providers for standing by the NHIS especially during trying times where claims redemption had delayed and pledged that the introduction of new payment policies such as the NHIS Capitation will help eradicate some of the challenges the Scheme and its providers often faced.
Meanwhile, he urged staff of provider facilities to study documents on the NHIS capitation in order that they become abreast of its details and adapt to them accordingly.
Mr Kasimu Abudulai who spoke on behalf of the Upper East Regional Director of the NHIA, disclosed that effective 1st December, 2015, the National Health Insurance Authority announced the upward adjustment of prices of over 88 percent of the 522 medicines on the medicine list with just a few of the medicines having their prices remain the same.
He noted that about 44 percent of the citizens in Bongo District were yet to the choose their Preferred Primary Provider and therefore charged service providers to strengthen their efforts in getting more clients to choose them as the preferred providers since the more clients a facility has is directly proportionate to the capitation it will receive from the NHIS.
In a presentation by Mr Abu Eric Kamboe, an Assistant Claims Officer with the Bongo NHIS, it came to light that 28 accredited facilities were rendering services to clients of the Bongo NHIS comprising the Bongo District Hospital, Health Centres, CHPS compounds and a private chemical shop.
Mr Kamboe suggested the timely submission of claims from providers; prompt claims reconciliation by both the NHIA and providers and use of permanent staff for claims processing at the provider-end as some ways of enhancing the NHIS system and injecting more efficiency into its work.
During open forum, some service providers alleged that staff of the NHIS were in the habit of visiting their facilities for inspection unannounced explaining such unannounced visits disrupts clinical services. Meanwhile, a provider from the Beo CHPS compound appealed to authorities of the NHIS to set up a field registration centre at the area so as to get more clients onto the NHIS.
Source: ISD (PETER ATOGEWE WEDAM, BONGO)