The National Health Insurance Authority (NHIA) has suspended processing of 2016/2017 claims it said were submitted late by service providers.
The decision according to the health insurance regulator is to enable it begin processing of claims submitted for January and February this year.
The NHIA has taken a decision to streamline its claims payment by reimbursing service providers on monthly basis. However, the delay in the submission of claims is affecting the monthly payments, the Authority has noted.
“In a bid not to unfairly withhold payments for those who make timely submissions, the NHIA has now put a hold on processing of 2016/2017claims received late (state claims). Providers are asked to submit a petition for any claims not submitted within three months (State claims),” contained in a circular to service providers and signed by Chief Executive Officer, Dr. Samuel Annor.
“This will enable the NHIA focus on payment of January and February 2018 claims. Please be advised that all late submissions beyond three months will now be made based on recommendations of an adjudication committee,” said the notice dated August 22, 2018.
Service providers unhappy
Meanwhile, some providers affected are displeased with the directive by the NHIA. They said the decision will make it difficult for them to pay their suppliers as well as their employees.
Others are also reeling under intense pressure from financial institutions from whom they took loan facilities to pay their creditors as well as employees as the interests on their defaulted payments continue to soar due to the delayed payments.