Sekondi, June 22, -GNA-The Sekondi Sub Metropolitan Health Insurance Scheme paid claims totalling 918,297.00 Ghana Cedis for 64,733 clients in 2007, Mr Charles Osei Amoako Enti, the Scheme Manager said on Friday. Speaking at the annual general meeting at Sekondi, he said the scheme paid 172,556.00 Ghana Cedis as claims for 24,362 clients in 2005/2006. Mr Amoako who was presenting his annual report for 2007, said the scheme registered a total of 93,890 members as at 2007, which represents 58 per cent of the total population of 162,123 from both the formal and informal sectors.
He said as at May 2008, the total registered clients increased to 120,001 representing 74 per cent of the population.
Mr Amoako said the total active membership stands at 110,242 representing 91 per cent of the total registered.
He said 53,656.00 Ghana Cedis was collected as premium in 2005, 74,302.00 Ghana Cedis in 2006 and 190,178.00 Ghana Cedis in 2007. Mr Amoako said challenges facing the scheme included delay in the payment of claims to healthcare providers due to late submission from the providers as well as human resource limitations at the scheme level. He said other challenges are inadequate training for staff, especially claims and accounts, failure of some clients to renew expired cards unless sick and inadequate claims support for the exempt.
Nana Ekra Kojo IV, Chairman of the Board of the Scheme, said the Board has set up a three-member claims vetting committee and is in the process of recruiting additional permanent claims officers in order to speed up the process of reimbursing providers. He said payment of claims is delayed for various reasons including delays in submission of claims by providers and inability of the scheme in vetting claims on time.
