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The National Health Insurance Scheme (NHIS) Ghana to introduce biometric identity cards which will be issued instantly at the point of registration to subscribers.
NHIS will start on piloting electronic claims (E-claims) processing and host an extended stakeholder review of the capitation pilot in the Ashanti Region to inform its improvement and the subsequent nationwide roll out of this provider payment method.
Plans to put in place three more claims processing centres in the Northern, Central and Ashanti regions are underway as they will serve as a complement to the centre in Accra. This would complete efficiency measures into claims management nationwide.
The Chief Executive of the National Health Insurance Authority (NHIA), Mr Sylvester A. Mensah said that subscriber satisfaction was a key performance indicator for the NHIA, therefore, a subscribers’ handbook showing the benefit package, medicines and subscriber rights and obligations would be compiled and made available to all subscribers at the point of registration and membership renewal.
Also, the NHIS medicines list/pricing would be reviewed to reflect market realities.
He further said the authority would begin modernising and transiting from an ICT concept, “which places more emphasis on infrastructure, to a management information system (MIS) which places premium on generating information for management decision-making”.
NHIA will partner with the Ghana Medical Association (GMA) in fulfilling its mandate .The president of GMA asserted that the GMA would continue to be a strong ally of the NHIS and would collaborate with the authority on the rollout of capitation across the country, if all their concerns were addressed.
He further said that GMA would continue to constructively criticise the NHIA to ensure that the scheme stands the test of time.
It would also start work on piloting electronic claims (E-claims) processing and host an extended stakeholder review of the capitation pilot in the Ashanti Region to inform its improvement and the subsequent nationwide rollout of this provider payment method.
NHIA future plans include establishing three more claims processing centres in the Northern, Central and Ashanti regions, to complement the centre in Accra. This, he maintains, would complete efficiency measures into claims management nationwide.
Among other numerous initiatives, Mr Mensah revealed plans to re-brand the scheme consistent with the new law, new vision and mission and operational architecture of the NHIS, adding that the financial manual of the NHIA would also be revised to place greater responsibility on the centre to prevent the abuse and fraud occurring at the regional and scheme levels.
In addition a permanent and joint clinical and claims audit team would be established to undertake forensic claims audit across the country all-year round to track isolated cases of connivance between schemes and providers.
Mr Mensah mentioned that subscriber satisfaction was a key performance indicator for the NHIA, therefore, a subscribers’ handbook detailing the benefit package, medicines and subscriber rights and obligations would be compiled and made available to all subscribers at the point of registration and membership renewal.
Also, the NHIS medicines list/pricing would be reviewed to reflect market realities.
He further said the authority would begin modernising and transiting from an ICT concept, “which places more emphasis on infrastructure, to a management information system (MIS) which places premium on generating information for management decision-making”.
NHIS would work together with GMA to fulfill its mandate. Ghana Medical Association (GMA), Dr Kwabena Opoku-Adusei while addressing stakeholders, gave an assurance that the GMA would continue to be a strong ally of the NHIS and would collaborate with the authority on the rollout of capitation across the country, if all their concerns were addressed.
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