NHIS service providers must exhibit professionalism

Service providers of the National Health Insurance Scheme (NHIS) in both public and private health institutions, have been advised to exhibit high professional standards and customer care to woo their clients to enroll with the capitation module.


NHIS accredited health facilities stand to benefit immensely from the Capitation Module, described as a more proactive means of sustaining the NHIS by its efficient advance monthly claim payment system to cater for urgent operational costs incurred by service providers.


The Capitation Module piloted in the Ashanti Region some four years ago, would be rolled out in the Eastern Region in a few months.

Mr Anthony Gingon, Director of Claims and Payments, at the National Health Insurance Authority (NHIA), said under the capitation module, clients would choose their own Preferred Primary Provider (PPP) and therefore service providers which did not exhibit good front-line and general customer care could lose out.

The Director of claims who gave the advice at a capitation training workshop for stakeholders in the Eastern Region at Koforidua, indicated that since money would be paid in advance under the capitation module based on number of clients enrolled with a particular facility, customer care and professionalism were critical.

The stakeholders included District Directors of Health, owners and managers of health facilities that are registered with the NHIS as service providers, pharmacists, in-charges of Comprehensive Health and Planning Services (CHPS) compounds and NHIA District Directors across the Region.

The workshop forms part of the arrangements by the NHIA to educate and sensitize stakeholders in the Region for the smooth take-off of the NHIS capitation module in the Region.

Mr Gingon, explained that under the capitation, clients would be allowed to change their PPP every six months adding that “that is why heads and owners of facilities must be conscious of their customer care and professionalism to keep the clients”.

“The capitation module is expected to deal with the challenges in payments of NHIS claims such that at least operational cost incurred by the service providers could be taken care of urgently.

By Bertha Badu-Agyei, GNA

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