Digitalization of health insurance: Nationwide Medical Insurance leading the way

The World Bank is on a mission to help Africa build a strong digital economy that leaves no one behind. Here in Ghana, the call for digitalization of business operations has been rife. Indeed, the government is championing this course by digitalizing some sectors of the economy.

This is evident with the introduction of the National Identification Scheme, digital address system, land and title administration, digitization at Registrar-Generals Department, Birth and Death Registry, passport application centres among others.

At a recent World Bank Spring meeting which focused on the digital economy, various speakers including the Minister of Communication Mrs. Ursula Akuffo stressed on the need for entrepreneurs and businesses to embrace digitalization as a sustainable way of doing business.

The banking and telecommunication industries have relatively advanced with digitalizing their products and services. Other industries are gradually embracing this whiles some have ignored it. The insurance industry has had little to boast of on the subject of digitalization.

During this year's annual lecture of the Chartered Insurance Institute of Ghana, insurance companies were urged to embrace digitalization. However, it is worth mentioning that Vanguard Assurance, early this year has launched a flagship digitalized service called Telematics.

The healthcare sector in Ghana has achieved some level of digitization with some hospital administration applications but they are taking much longer to digitalize. Industries have adopted the internet of things (IoT) and digitalization to make their operations efficient and improve the user experience of their services. The health insurance industry cannot afford to move slowly in this digital era and as such needs to digitalize its operations, product and services.

It is against this backdrop that Nationwide Medical Insurance is poised to revolutionize the health insurance industry with digitalization. It is leading the pace by introducing innovative digital tools that would enhance its operations in the health insurance sector.

The purpose of going digital is to make Nationwide Medical Insurance more efficient with claims processing and payment, provide delightful customer experience, giving value to stakeholders as well as having a competitive edge. Digital tools like mobile and software applications, web portals, telemedicine etc. have been employed by Nationwide Medical Insurance to achieve this purpose.

Electronic Benefit Management & E- Claim

In 2016, Nationwide Medical Insurance introduced the flagship RX claims software for service providers to verify members and their benefits. It also enables service providers to submit claims electronically. This novel software has enabled healthcare service providers to reduce the use of paper. Claims are sent electronically by service providers to NMI from the convenience of their offices.

In the first year of introducing the RX claims software, it gained about 90% acceptance rate in the Greater Accra Region and two years down the line, the acceptance rate of service providers across Ghana is at 76%. Due to its enormous benefits and user-friendly features, the electronic claims RX software has been adopted by a lot more health insurance companies.

Today, Nationwide Medical Insurance has drastically reduced costs incurred from printing claim booklets as well as the cost of archiving claim forms.

Nationwide Mobile Apps

The Nationwide RX mobile app, which is downloadable from Google Playstore and iOS, assists subscribers to locate a health service provider and rate services of these providers. The app also enables subscribers to check their historic medical records, healthcare costs and other useful health data that helps them to make informed decisions about their health.

With this tool, healthcare consumers are empowered to take charge of their healthcare and contribute towards improving their healthcare experience. As at the end of April 2018 the app had received over 1000 downloads.

Mobimed Mobile App

In the past, subscribers of Nationwide Medical Insurance faced the challenge of moving from one pharmacy to the other to fill their prescriptions. In some cases it took them several hours to get them filled. This challenge has been resolved with the introduction Mobimed. Mobimed is a mobile delivery service which conveniently delivers prescribed medications to the subscribers in the comfort of their offices. This is achieved by the subscriber uploading the prescriptions to the mobimed app. Prior to this development, this was done via sending prescriptions and membership details via Whatsapp to the mobimed pharmacy delivery service.

E-prescription

Even though claims were being submitted electronically by Pharmacy Service Providers, there was still the need to submit paper prescriptions to the claim office for adjudication of pharmacy claims. This led to delays in claim processing and in some cases loss of revenue to pharmacies as prescriptions were misplaced.
In order to curb this Nationwide Medical Insurance is piloting an app which allows pharmacy service providers to submit pictures of these prescriptions. The prescriptions are attached to the electronic claims, thus removing the need to submit paper claims. This has led to fewer cases of loss of prescriptions and shorter processing times for pharmacy claims. The pilot has been largely successful and the app would be deployed to all health service providers who send claims that require attachments.
Virtual Healthcare

Nationwide Medical Insurance is exploring virtual healthcare with telemedicine; this is a convenient way to receive healthcare and medical advisory without having to be physically present at the health facility. With this Nationwide Medical Insurance could set up an onsite virtual clinic for corporate subscribers at their request; Telemedicine would further reduce congestion at clinics and healthcare costs. It has been proven to be very effective especially during emergencies. At the click of a button, subscribers can access healthcare by professional medics virtually. This saves time, convenient and economical.

Human Resource Portal

Human resource representatives of our corporate subscribers have an online portal from which they can have easy access to information and conveniently amend information such as additions and delisting of their members insured with us. The portal also enables the representatives to electronically request for card replacement, and upgrade of member health plan. This has made it much easier for the insurer in registering members into their database and has significantly reduced the processing time in membership card printing and distribution.

E-Cards

One of the ways of identifying an eligible member is with their membership cards; however, some members misplace the cards and in some cases forget the cards when visiting a healthcare service provider. This is likely to prevent clients from accessing healthcare. To prevent such occurrences Nationwide Medical Insurance has come up with a smart way to identify members with the introduction of e-cards. The e-card has the same semblance as the plastic membership cards and is normally on smartphones which subscribers carry along with them all the time and at the point of accessing healthcare. With this, subscribers have a seamless healthcare service from service providers.

Use of mobile technology

Due to the high penetration of mobile money services especially with the informal sector, Nationwide Medical Insurance has leveraged on this and created an opportunity for subscribers to use mobile money platforms as a means for premium collection and claims reimbursement.

Subscribers can carry out these transactions right on their phones using mobile money. The use of USSD codes have been employed for the subscribers of our new product 'My Health'. The USSD code is a convenient way to enable potential subscribers to use shortcodes as a means to be enrolled unto our health insurance package; this has made it simpler for prospective subscribers to get registered with Nationwide Medical Insurance. It has removed bottlenecks associated with manual registration of new subscribers. The process does not require internet connectivity.

New Media

Nationwide Medical Insurance has taken advantage of social media to reach to its online community; it has 9981 and 95 followers on Facebook and Twitter respectively. In 2017, the account was ranked first as the private health insurance company in social media engagement by Ghana Digital Index. Nationwide Medical Insurance's corporate website has been redesigned to be more engaging with the introduction of the live chat feature which enables visitors to the site to get immediate real-time responses.

Data Protection, Security & Privacy

Data protection and security is of high priority to Nationwide Medical Insurance. Health data is treated with utmost confidentiality. It has put in place requisite IT protection and infrastructure to ensure the privacy and security of health information of their subscribers and this is also extended to the users of their digital tools. Nationwide Medical Insurance is duly certified by the Data Protection Commission and is in full compliance with the data protection act of Ghana

Conclusion

Digitalization offers individuals and organizations opportunities to improve their products services as well as deliver ease and convenience to improve quality of life.

Nationwide Medical Insurance is excited to see how these digital innovations would impact positively on our subscribers and stakeholders to make their experience delightful.

The aim is to create an exciting and delightful experience for all stakeholders.