NHIS

The Awutu-Effutu-Senya District Directorate of the National Health Insurance Scheme (NHIS) has as at November ending achieved 86 percent of its set target of 158,200 for the year.

Mr Christopher Oddoye, District Manager, said this at a-day’s Stakeholders Engagement held under the theme: “The Collaborative Effort of all Stakeholders in Achieving Quality Basic Healthcare towards Universal Health Coverage as the ultimate goal”.

He said 95 per cent mobile renewal targets was also achieved increasing the active membership of the Scheme to 135,972 in November and hoping to achieve more than 100 percent by December ending.

The District Scheme Manager said it is the long-term goal of the National Health Insurance Authority (NHIA) to provide financial risk protection against cost of primary health care for all in the country.

“As part of our achievement during the year, we established a new registration center at the North Campus of the University of Education Winneba (UEW) to serve the university community and we were able to record over 100 percent of our set revenue targets”.

“We will intensify and sustain public education on the NHIS to project a positive corporate brand and image that promotes excellent relationships between NHIA and its stakeholders and among others”, he said.

Mr Oddoye said the frequent system and network down times, intermittent interruption in the production of membership cards, difficulty in securing permanent registration center for Bawjiase, high utilization rate and claims payment were some of operational challenges of the Scheme.

For efficient operation, he said, there should be prompt payment of claims to providers and re-engage inactive service providers, especially pharmacies and chemical shops that are inactive.

Other measures are consistent clinical audit to check the eligibility of claims by service providers, timely review of tariffs and medicine lists to bridge the massive gap between NHIS prices and market price basis.

The support from institutions and development partners and application of sanctions on co-payment and top ups must be looked at to chart the way forward for the Scheme, he said.

The District Manager appealed to the providers to recommend NHIS to all the cash paying members towards Universal Health Care and also safeguard them against future financial difficulties.

Mr Emmanuel Mensah Frimpong, Acting Central Regional Manager of Claims Processing Center of the NHIA, urged health care providers of NHIS facilities to have permanent and trained claims officials to work on their claims and to set up vibrant vetting committees to pre-vet claims before submission.

“You should also put in place proper supervision of your facility’s claims staff, pay attention to the monthly vetting report and ensure the validation of clients eligibility to guarantee that they are eligible at the day of service to avoid any hinderance in the payment of their claims”.

The NHIA cherishes the partnership that it has with accredited health care provider and would ensure that providers received full reimbursement of service provided to its clients to keep them running, he said.

Mr Samuel N. Oppong, Central Regional Director of the NHIA, expressed his appreciation to the stakeholders for their unique roles which has brought the NHIA thus far and expressed the hope that they will continue to contribute their quota to achieve quality basic health care for all.

Dr David Mellauo, Acting Medical Officer in charge of Kasoa Poly Clinic, appealed to government to invest more in public health care saying this will save the nation.

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