Health insurance providers advised to follow laid down rules

Mr. James Adu-Bona, Brong-Ahafo Regional Health Insurance Claims Manager, has advised health insurance service providers in Dormaa Municipality to follow laid down practices in preparing their claims to avoid delays and rejection by vetting bodies.

He gave the advice when he addressed a one day workshop for claim administrators in Dormaa-Ahenkro.

The workshop, jointly organised by the Dormaa Municipal Mutual Health Insurance Scheme and the Presbyterian hospital in Dormaa Ahenkro, was designed to equip participants with knowledge and information in the preparation of accurate and claims and the avoidance of long vetting processes and attendant delays.

Participants were taken through basic requirements on the NHIS claim form and were schooled on the “dos” and “don’ts” while preparing claims.

Mr. Adu-Bona who is also the Scheme Manager for Nkoranza noted that some service providers in their quest to make more money for their facilities or offer sympathy to clients tended to engage in moral hazards and provided room for suspicion on their claim forms.

He advised billers to keep within the confines of the rules of the game so as to lessen the burden on all parties involved in the preparation, vetting and payment of NHIS claims.

“As the Health Insurance gradually assumes national features, it is important that we avoid basic mistakes in our claims and encourage similar practices everywhere to guarantee even access and treatment in all parts of the country”, the regional health insurance claims manager added.

Mr. Adu-Bona tasked claim administrators and service providers to stick to best practices, saying that was the surest way their bills could be honoured promptly.

Ms. Florence Iddrisah, Dormaa Municipal Health Director, appealed to the National Health Insurance Authority to consider granting same billing system for all facilities as different bills for different categories of service providers had provided cause for complaints among beneficiaries of the scheme.

She explained that government health institutions charged differently from private and Christian Health Association (CHAG) facilities and where two different facilities were located in the same community, there was bound to be room for such complaints.

The Dormaa Municipal Health Insurance Scheme Manager, Mr. Martin Amponsah stressed the need for service providers and the scheme to forge a unified front in their quest to attain the common goal of guaranteeing quality basic health care to the people.

He stressed that his office was not out to victimize any biller but to ensure that the right procedure was strictly adhered to in all cases to avert lapses and any query.

Participants at the workshop appealed to government to consider recruiting separate claim administrators for the facilities as what they termed “additional responsibility” was taking a toll on their work as health staff.

Source: GNA

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