The Sunyani Municipal Health Insurance Scheme received an amount of GH¢5,578,061.88, out of which GH¢5,250,889.68 was provided by the National Health Insurance Authority (NHIA), Mr Isaac Afari, Scheme Manager, announced on Tuesday in Sunyani.
He said the remaining GH¢327,172.20 was the collection of premium and processing fees from clients, saying that, internally generated fund was only six per cent of the total income and the remaining 94 per cent was from government.
Mr Afari, who was addressing a mid-year review meeting of the scheme and its accredited health care providers, lauded the government for the huge financial support for the sustenance of the Scheme.
“The current huge releases of fund from the NHIA for the payment of claims throughout the country, shows the Government’s commitment to sustain the NHIS”, he stressed.
The scheme manager said the Sunyani scheme paid to its health care providers in the municipality an amount of GH¢5,124,211.94 in medical bills and prescribed drugs for a total attendance of 245,354 from January 1 to June 30 this year,.
Mr Afari explained that these payments represented unpaid claims of GH¢2,086, 172.96 from previous years.
He indicated that the scheme had paid all the accredited health care providers their claims, which they submitted to it, whilst in the case of all pharmaceutical and chemical shops, payment had been made.
Mr Afari disclosed that, the scheme management, through proper vetting of claims from health care providers, had saved the scheme an amount of GH¢153,517.07 within the period.
He said the scheme’s membership status currently stands at 216,223 within the Sunyani Municipality, and that, it covered 87.19 per cent of the estimated total population of the municipality.
He said from January to June this year, the scheme registered 14,232 new members and also renewed the membership of 34,900 existing clients, and gave the assurance that “the scheme will not relent on this effort and that they were determined to register at least 90 percent of the people within the municipality”.
Mr Afari said the Sunyani scheme was now in partnership with 38 accredited health providers, made up of nine in the public sector, seven in the private sector, two CHAG (Christian Health Association Group) institutions, six maternity homes, three investigation centres and 11 pharmaceutical and chemical shops.
He urged health care providers to operate within the confines of the NHIS Law, advising that, the providers must prescribe drugs that were within the insurance benefit package.
Mr Foster Agyei-Korang, Brong-Ahafo Regional Manager of the NHIA, who presided over the meeting, said from January to July this year, government, had disbursed GH ¢41, 263,158.40, for the payments to all providers in the region.
He, however, noted that, a major challenge in the system was the delay in the submission of claims from some of the service providers and urged them to do so early for vetting, processing and payment.