NHIS owes Volta Regional Hospital over GH98,000

Ho, Aug. 3, GNA - The National Health Insurance Scheme (NHIS) owes the Volta Regional Hospital over 980 million cedis unpaid claims from March to June this year.

As a result the Hospital is unable to make adequate procurements for logistics to run the facility.

Mr Alex Amenu, Volta Regional Health Administrator said this on Friday at a meeting organized by the Regional Health Committee for health service providers, NHIS scheme managers and other stakeholders of the Scheme in Ho.

He stated that though the National Health Insurance Scheme was the "finest thing" to have happened to Ghanaians, its operational challenges were becoming enormous and needed to be addressed in time. Mr Amenu expressed worry about the delay in reimbursement and rejection of claims without any information to the facilities, as well as the lack of dialogue between service providers and insurers on claims management.

He called for prompt verification of bills for faster reimbursement and upfront payment if necessary, in the interest of the Scheme. However, Mr Prosper Pi-Bansah, Claims Manager of the Ho Municipal District Mutual Health Insurance Scheme, attributed the delay of reimbursement to late submission of bills and accused service providers of submitting false claims with insufficient information.

He accused medical practitioners of "multiple diagnoses, over servicing. "Some even prescribe treatment without diagnoses". Dr Atsu Seake-Kwawu, Keta District Director of Health, said multiple diagnoses were sometimes needed for a complete treatment of patients and said the major problem concerning reimbursement was the tariff structure, which he added, had outlived its usefulness. He underscored the importance of the NHIS to the socio-economic development of the country and urged government to consider the employment of Higher National Diploma holders "with good analytical minds" to help in the management of the Scheme.

Dr. Andrew Arde-Acquah, Volta Regional Director of Health Services appealed to service providers and Scheme managers to work together in a "win-win" environment giving room to dialogue to ensure the success of the Scheme.