Bongo District Manager of the National Health Insurance Scheme (NHIS), Mr. Mahamadu Seidu Akugri has expressed his displeasure over delays in submission of claims by health service providers accredited under the scheme remarking that the undue delays often affects the smooth procedure of paying claims.
Mr. Akugri revealed that some NHIS service providers across the Bongo District have since not submitted their claims to his office dating as far back as July, 2015.
Bongo District Manager who expressed his worry over the delay in claims submission at the scheme’s review meeting with service providers held in Bongo urged the service providers to diligently examine claims vetting reports issued by the scheme in order not to repeat mistakes that lead to deductions in claims.
Mr. Akugri admonished authorities to avoid focusing their attention only on the claims cash while ignoring vital information in the vetting reports such as reasons for particular deductions by the NHIS so as to avoid cuts in claims submitted.
While pledging the elimination of some challenges the scheme and its providers often faced as a result of the introduction of new payment policies such as the NHIS capitation, he commended the providers for standing by NHIS especially during trying times where claims redemption had delayed.
Mr. Akugri has therefore entreated 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.
Kasimu Abudulai who spoke on behalf of the Upper East Regional Director of the NHIA, Sebastian Alagpulinsa 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 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.
Assistant Claims Officer with Bongo NHIS, Abu Eric Kamboe in a presentation revealed 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.
In order to enhance the NHIS system and injecting more efficiency into its work Mr. Kamboe reiterated 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.
Some service providers during the review meeting expressed their displeasure that staff of the NHIS in the district 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.
By: Joshua Asaah/A1radioonline.com/Ghana
