Scrutinize claims properly; heads of health facilities told

Dr John Ekow Otoo, Agona East District Director of the Ghana Health Service (GHS), has called on heads of health institutions to involve themselves in the operations of their claims departments to ensure excellent results.

He said this will instill a high sense of discipline in their claims preparation officers in their respective health facilities.

Dr Otoo said this when addressing service providers of the National Health Insurance Scheme at a meeting organized by the Agona Swedru area branch of the NHIA.

Participants included thirty service providers drawn from both Agona East and Agona West Administrative areas.

Dr Otoo said the misunderstandings which occur between managements of the various NHIA accredited healthcare facilities and the authorities of the Health Insurance Scheme could be avoided if leaders of these facilities scrutinized the work of their claims officers.

He expressed the hope that heads of accredited facilities in the two Agona Administrative institutions would devise effective means of handling the claims and preparation challenges facing their institutions.

Messrs Emmanuel Mensah-Frempong and Robert Brandford-Mensah Claims Manager and Monitoring and Evaluation Officer respectively of the Central Regional Directorate of the Health Insurance Scheme, took turns to educate Service Providers on all the important aspects of claims preparation and vetting procedures, as well as the monitoring and evaluation functions being practiced by the NHIA.

Mr Mensah-Frempong cautioned Service Providers against multiple billing of Health Insurance Clients and other negative practices used to undermine the financial capabilities of the Health Insurance Scheme.

Mrs Nancy Ekyem, Agona West Municipal Director of the Ghana Health Service (GHS), called on Service Providers in the two Administrative Areas to constitute Vetting Committees for their respective Health Facilities as directed by the Ministry of Health to improve their Claims Processing lot.

Mr Josiah Doam Kittoe, Agona Swedru Area branch Manager of the National Health Insurance Authority (NHIA), said that the essence of ensuring that Service Providers strictly abide by the laws, laid down regulations and guidelines governing the operation of the Health Insurance Scheme, was to ensure a lasting sustainability of the Policy so that future generations would also benefit from the Policy

Dr Dzedzogbe Apetorgbor, Medical Superintendent in-charge of the Agona Swedru Municipal Hospital, said there was the need for medical experts to be posted to District Hospitals in the Region to handle major health challenges confronting them.

He also called on the Authorities of the Ghana Health Service and the Management of the National Health Insurance Authority to ensure a regular review of the approved drugs for the operation of the NHIS to include new and more effective drugs on the market.