The National Health Insurance Authority (NHA), Chief Executive has reprimanded all credentialed healthcare service providers to be transparent with the public on Claims payments made for services rendered to active members of the National Health Insurance Scheme (NHIS) at the point of need.

 Dr. Bernard Okoe Boye, on August 25,.2023, in Accra was addressing the opening ceremony of a training program sponsored by the World Bank Group. 

The participants were from the Ghana Health Service (GHS), Private Healthcare Providers, Christian Heath Association of Ghana (CHAG) facilities, and staff of NHIS Greater Accra Regional and District offices, among others. 

The World Bank Group support aims to improve NHIS active membership drive as well as Claims submission, processing, and payments for Tier Three service providers such as Health Centers, Maternity Homes and CHPS compounds. 

The four-year World Bank Group support spans from 2022 to 2025 and it is based on disbursement indicators on increased Membership Enrollment with much emphasis on indigents and the ability to process and pay claims of TIER 3 health facilities within 90 days from the date of submission. 

Dr. Okoe Boye lauded the training program and anticipated that it would empower service providers to timely submit Claims and prevent undue delays in the processing and payments. 

He emphasized the importance of service providers constantly providing relevant information to the public regarding monies paid to them for healthcare services covered by the NHIS. 

This, according to him will be in complete consonance with the NHIA's Sunshine Policy, which deepens accounting, transparency, and social auditing of Claims payments.

 "I charge you providers to come out clean as we have demonstrated through the Sunshine policy whereby Claims payments are published online. A total of 1.2 billion cedis has been paid for the first half of the year 2023.  We are really working but we all need transparency in discharging our duties." 

In a speech read on behalf of the Health Minister, Mr. Kwaku Agyeman-Manu said it was vital to strengthen Ghana's health ecosystem through well-coordinated collaborations.

 He reminded all healthcare service providers to desist from demanding extra money (illegal payments) for services covered by the NHIS.

"Although the Ministry recognizes the challenges providers face in providing healthcare at the primary level,  you are entreated to desist from illegal payments and rather have a common vision to  work towards a healthier Ghana."

The World Bank Group's representative, Mr. Enoch Oti Agyekum commended the NHIA management for taking the initiative to train its primary healthcare providers on efficient Claims generation, submission and payments.

"Strengthening the primary healthcare system is an important pillar to achieve UHC as most of the patients at the lower level cannot afford to pay for their health needs." 

He highlighted the NHIA’s high performance on increased population coverage in Africa stating that "Ghana stands next to Rwanda although the two countries have different context." 

He commended the NHIA for taking pragmatic innovative solutions geared towards making basic healthcare accessible to every Ghanaian. Mr. Enoch Oti Agyekum reassured that the World Bank Group will continue to provide technical support to improve the NHIA’s purchasing support. 

The Executive Director of Christian Health Association of Ghana, Mr. James Duah as well as Representatives from the GHS addressed the participants. 

Source: Lydia Kyeremaa Owusu