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The National Health Insurance Authority (NHIA), Cape Coast Claims Processing Centre (CPC), has organized a three-day stakeholder engagement seeking to address critical challenges encountered by the Authority’s credentialled healthcare providers. From the Western North, Western, and Central Regions, the key stakeholders were briefed on the latest developments regarding Claims generation, submission, and adjudication for lower-tier service providers.
They comprised the NHIA staff from the Claims, Quality Assurance (QA), and Management Information Systems (MIS) Directorates, Head Office, staff of the National Health Insurance Scheme (NHIS) District Offices, representatives of the various District Health Directorates (DHD) of the Ghana Health Services, the Health Facilities Regulatory Agency (HEFRA) and lower-tier healthcare providers.
A member of the NHIA Governing Board, Dr. Isaac Charles Noble Morrison, reinforced the Authority’s commitment to improving healthcare access and Claims systems. He emphasized NHIA’s collaborative projects with international partners, such as the World Bank to achieve Universal Health Coverage (UHC) by the year 2030.
The Acting Director of Claims, Dr. Mrs. Abigail Nyarko Codjoe Derkyi-Kwarteng encouraged healthcare providers to openly share challenges in Claims generation and submission, underscoring the importance of accuracy and timely submissions to avoid delays in reimbursements. She also stressed the need for continuous credentialing updates and adherence to NHIA standards.
The discussions highlighted electronic Claims management and credentialing, which aims to streamline and improve the accuracy and timeliness of Claim submissions. The Cape Coast CPC, Acting Deputy Director of Claims, Dr. Abena Ekufua Esia-Donkoh shared strategies for enhancing accuracy and efficiency in Claims adjudication.
A Manager from the Quality Assurance Directorate, Ms. Abigail Asalu, talked about electronic credentialing processes, highlighting common challenges and post-deployment issues. A Claims Manager from Accra CPC, Mr. Eric Komla Nazar, led an in-depth session on Electronic Claims Management, addressing system updates and the needed support available for healthcare providers.
The NHIA Regional Directors and Regional Health Directors from the Ghana Health Service in their addresses emphasized the importance of collaboration among healthcare stakeholders to resolve recurrent Claims processing challenges.
Source: Elijah Sam Danso (CPC- Cape Coast)
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