The National Health Insurance Authority has organized a stakeholders meeting specifically for healthcare providers to address some concerns and policy directions for the scheme.
The meeting was focused on Claims Management which according to the Regional Director of National Health Insurance Authority Mrs. Edna Gyau Baffour, is one of the core players in the national health insurance authority.
In an exclusive interview with Shella Ama Boaduwa, Mrs. Edna Gyau Baffour stated that, the NHIA has
introduced new logistics to help in the fast processing of their claims and insurance ID
She further stressed on the delay in submission of claims by providers in areas such as Takoradi.
She further posited that the NHIA is working on going digital in order to reduce stress involved in the
manual processing of claims and to create digital money mobile platform for the renewal of registration.
The initiatives of the national health insurance authority to engage their stakeholders so that they can
together plan and understand what they are doing together as stakeholders. So they called for a meeting
mainly for the stakeholders specifically the healthcare providers to address some concerns and policy
directions for the national health insurance authority.
Specifically the focus was on claims, though they addressed some general issues or concerns bothering on the NHIA, the focus on today’s engagement was to address concerns bothering on claims management which is one of the core players in the national health insurance authority.
It is a regular feature on their program of work to engage stakeholders regularly so that they don’t keep
them in the dark. Since they consolidated the claims to the claims processing centre in cape coast, they
have not had any engagement with their providers in the western region.
Yet so they thought it wise that the next engagement should be held in the western region so that they can have an engagement with them.
In recent times there have been new medicines list which saw about 30% reduction in the prices of some
of the medicines and reduce errors and abuses in claims, frauding the in claims.
There have also been a number of new policy interventions from the national health insurance authority
and then they have concerns with delays in submission of claims from the providers, and certain other
things. So the decision was made to come to the Western Region to put all these things together and
engage their stakeholders in order to foster a common understanding of what is expected of each of them.
The bottom line is that, the sustainability of the health insurance scheme depends on both parties so they need to be on a common platform, to be transparent with some of the policy directions that are coming up.
They need to get the buy-in of their providers with regards to some of the policy directions and some of
the trends that they are observing in the submission of claims which is not promising.
The digital mobile registration is going to help with processing of the claims and allow customers get
easy asses to their insurance cards. She said the mobile digital will send feedback to them from the
customers which will aid record and database management in marking the number of people who register and it rollout claims that comes monthly to ensure of their budget they have to spend or they have spent so that payment becomes easy.
The provision of authentication from users will enable the communication with their system to send notifications to customers without internet charges.