The National Health Insurance Authority (NHIA) in partnership with the National Identification Authority (NIA) will from next year commence the use of biometric verification of all its clients who access health care under the National Health Insurance scheme (NHIS).
The move is to enable the Authority effectively audit claim presented to the Scheme by service providers and eliminate the incidence of fraudulent claims that has since bedevilled the Scheme.
Dr Bernard Okoe Boye, Chief Executive Officer (CEO) of the NHIS disclosed this when he led a delegation to pay a courtesy call on President Nana Addo Dankwa Akufo-Addo at Jubilee House to brief him on developments at the Authority.
He was concerned that one of the major challenges facing the Scheme has had to do with the fact that documentation for claims by service providers has often been fraught with fraud.
The new system will however enable the scheme verify claims made by hospitals as each client will have their identity verified through the National Identification system.
“Starting next year, we are going with the National Identification Authority system. Every Ghanaian, (it will be phased), when you go to the hospital, you will be biometrically verified before you are seen so that before the month ends, I know that Komfo Anokye saw to 5,000 patients. They [hospitals] can’t send me [NHIA] bills of 6,000 people. That alone will cut out the fraud in the system,” he stated.
Dr Okoe Boye explained that the new policy is part of efforts by the Authority to address inefficiencies in the system by attaining a fully functional electronic management of claims under the scheme by the first half of next year.
Again, he disclosed that from January next year some service providers will be called to account for claims made to the Scheme and others will have their status as service providers revoked.
He bemoaned the current phenomenon where about 70% of all monies to the Scheme are used in paying claims but was hopeful that a fully digitised system will help cut out waste in the system.
Other updates to the president included the intent of the Scheme to increase its membership from 17 million subscribers to 18.3 million by the end of year amounting to some 57% of the Ghanaian population.
It is estimated that an average of some one million Ghanaians visit the hospital using the NHIS card annually which bill is paid by the Authority and this the Chief Executive Officer of the Authority say his outfit is working at further improving the ease of access
“Our Immediate objective is to improve how people access the scheme”, he added
Dr Okoe Boye explained that as at December 2018 the Authority had introduced the short code which allowed members to renew their membership on their mobile phones.
This, he said has resulted in about 13 million out of the 17 million people to renew their subscription without having to move to an NHIS office.
Additionally, the CEO updated the President on new claims under the Scheme which include four childhood cancers, an important medication for breast cancer and sickle cell treatment which have now been added to treatments under the NHIS with prostate cancer treatment soon coming on board.
He explained further that upon assumption of office, the Schemed owed some service providers up to about 14 months arrears but said the Authority has since paid claims up to April this year.
Dr Okoe Boye called for a national conversation on a possible review of the current processing fee of GH₵6 SSNIT subscribers and the GH₵26 for premium contributors as these fees are too low to help the Scheme operate sustainably.
President Akufo-Addo on his part commended the staff, management and board of directors for their transformative agenda at the Authority.
The President said the decision to introduce biometric verification of NHIS users was timely and a brilliant idea.
“I think the biometric verification of patients is also another very important step in trying to give some rigor to the scheme so that as much as possible, claims [are] verifiable and in real time not that you have to wait for hours for audits, etc. All of these are very important” President Akufo-Addo said.
He pledged governments continued support to enable the Authority deliver effectively on its mandate.
“So, all I can say is, to all of you, from the chairman, through you, the chief executive and members of the board the deputies, is to congratulate you on the work that you are doing on behalf of our country. It is important that government and the society in general, mobilizes as much as possible, to support the work that you’re doing”
By Daniel NONOR || The Finder, Jubilee House