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Health News of Thursday, 26 February 2015


‘Delay in NHIS claims not excuse to reintroduce cash and carry’

The acting Brong Ahafo Regional Director of the National Health Insurance Authority (NHIA), Mr Sebastian Alagpulinsa, has asked with healthcare providers not to use the delays in reimbursement of claims to bring back the cash and carry system in healthcare facilities in the country.

“I want to sincerely admit that it has not been easy in reimbursing our providers as expected. There had been delays in reimbursing providers but that should not under any circumstance serve as a panacea for cash and carry and co-payment at the provider site,” he stated.

Mr Alagpulinsa was presenting the 2014 Annual Performance Review of the scheme in Sunyani in the Brong Ahafo Region on the theme: “Eleven years of NHIS implementation in the Brong Ahafo Region, success, challenges and the way forward.” Participants included staff of the scheme from the region and other stakeholders in the health sector.

He noted that the delays in the reimbursement of claims by the scheme had affected the confidence reposed in them by their subscribers as it had also slowed down their membership drive in the region.

“We must be quick to admit that the delay in payment to providers might be a contributory factor but we want to assure our service providers that frantic efforts are being made to clear the arrears owed them,” the manager indicated.

According to him, “The high utilisation of health services by our subscribers and in other instances, recycling of claims by some providers, brought us unnecessary high claim cost.”

Mr Alagpulinsa said the scheme had paid claims up to July 2014 with a total cost of GH¢44,381,429.29 for utilisation of 2,399,449 of both out-patient and in-patient departments.

According to him, when this was compared with the same period in 2013, the claims cost as of July was GH¢37,276,189.49 with total utilisation of 2,120,260. He said the figures showed 19 per cent increase in cost and 13 per cent increase in utilisation.

He explained that as a strategy to strengthen the governance system and also improve on the scheme’s human resource capacity for effective performance, district managers, accountants and their assistants were trained on financial manual, the procurement law and other financial regulations.

The strategic interventions, he said, “were all meant to effectively market the NHIS to the public and improve technical and managerial capacity of our management and staff in the region”.

The Deputy Brong Ahafo Regional Minister, Mr Samuel Justice Adjei, said the scheme protected people from financial hardships occasioned by larger or unexpected medical bills.

“Without a doubt, the NHIS has improved access to healthcare services to different category of people in the country by removing significant financial barriers to access,” Mr Adjei said.

Touching on delays in reimbursement, the Brong Ahafo Regional Director of Health Service, Dr Timothy Letsa, entreated the management of the scheme to ensure that claims were paid on time to enable the service providers to work effectively.