Erratic payment of NHIS claims stifling operations at health facilities
From: Kwabena Owusu-Ampratwum-Luv Fm
November 16, 2012, 15:23 GMT
The Medical Superintendent Group of Ghana has said that the erratic payment of National Health Insurance claims is seriously impacting the ability of health facilities to operate smoothly.
According to the group, it has become virtually impossible to settle suppliers of medical products to hospitals and clinics due to the irregular payments.
President of the Group, Dr. Joseph Abebrese says this has led to the blacklisting of some facilities by suppliers.
Health facilities are supposed to receive their national health insurance reimbursements three weeks after the claims have been vetted, but that is not the case now.
Dr. Abebrese tells Luv News this is affecting the quality of health care delivery in many facilities.
He noted delays in payment for procurements have also creating rift between the superintendents and suppliers.
He says the situation has created a very stressful environment for the health superintendents who are in charge of running the hospitals.
They have no idea when their claims are going to be paid even after it has been vetted and an approval given for its payment.
According to him, this is creating a lot of strain between the service providers and suppliers some of whom are no more willing to render their services.
Dr Abebrese regrets some superintendents have been verbally assaulted by some suppliers whose payments have unduly delayed because the NHIA has failed to reimburse the health facility on time.
Dr Abebrese spoke to Luv News at the Annual General Meeting of the Medical Superintendent Group in Kumasi.
The meeting has brought together hospital heads from across the country to deliberate and find solutions to their challenges.
Dr Abebrese called for a review to the NHIS tariff regime which is unilaterally fixed by the NHIA.
He believes all the stakeholder should be involved in the fixing of appropriate tariffs to make up for price increases in the market.
The President of the Medical Superintendent Group of Ghana wants the establishment of an independent body under the auspices of the Health Ministry to handle issues of rejected claims.
This is because sometimes the NHIA rejects claims without giving any tangible reason and the health facilities are not given the opportunity to defend such claims, he said.
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