The authority is expected to make further payments in the next few weeks to cover January to March 2023 claims to bring the National Health Insurance Scheme (NHIS) back to a 90-day arrears window.

The Chief Executive of the NHIA, Dr Bernard Okoe-Boye, disclosed this in Tema last Tuesday during the official handover of a credentialing certificate to the International Maritime Hospital (IMaH) as a service provider of the scheme.

The intervention, he explained, meant that the authority technically owed providers only two months of claims for February and March 2023, adding that the NHIS was more resilient today and committed to doing even better

The credentialing process was to ensure that IMaH, which hitherto did not accept the NHIS system, provides basic quality health services to subscribers of the scheme.

Reimbursement

Dr Okoe-Boye said for the first time in several years, the government had released funds more rapidly to the NHIA, making it possible to pay on average GH¢150 million to GH¢200 million monthly as claims reimbursement to healthcare providers.

He said currently, 86 per cent of claims were submitted and vetted electronically as compared to nearly two years ago when claims were 80 per cent manually vetted.

That, he explained, had increased the turnaround time for vetting and reduced wastage and leakages, resulting in the authority’s ability to reimburse claims more promptly.

Dr Okoe-Boye said the NHIA had been responsive in adjusting its service tariffs paid to providers within the past year upwards, adding that the latest increment was in February this year when tariffs for medicines and services covered by the scheme were increased by 50 per cent for medicines in the framework contracting agreement plus an additional 30 per cent marginal increase.

He said non-framework medicines were reviewed upward by 20 per cent, while service tariffs across the board were increased by 10 per cent.

Dr Okoe-Boye said the authority had begun the consultative process to ensure that tariffs corresponded with market price movements going forward, stressing that “while we are working hard to deliver a robust NHIS, it is unfortunate that some health providers blatantly charge NHIS members some out-of-pocket illegal fees, making the scheme unattractive”.

He said the authority had set up a decentralised national committee against such illegal charges.

Membership

Dr Okoe-Boye said the current NHIS membership stood at around 17.2 million active members, representing about 55 per cent of Ghana’s population, and indicated that the authority was striving hard to cover at least 80 per cent of the population to attain universal health coverage (UHC) by 2030.

“Achieving UHC for Ghana also means that the NHIA must do well to expand geographical access to health care and work towards eradicating out-of-pocket payment at health facilities for its insured members,” he said.

While welcoming the IMaH into the NHIA family of service providers, Dr Okoe-Boye expressed the hope that the hospital would become a model facility that would uphold the tenets of health insurance and provide the quality of care desired by patients.

Appreciation

The Chief Executive Officer of IMaH, Dr Akwasi Afriyie Achampong, said the facility, a subsidiary of the Ghana Ports and Harbours Authority (GPHA), was a 130-bed ultramodern tertiary hospital with state-of-the art medical facilities.

He said the partnership with the NHIA further emboldened the hospital to provide top quality health care for the citizenry.

Community service

The Director of Port for Keta Port Development, Dr Alexander Yaw Adusei, who represented the Director General of GPHA, Michael Achagwe Luguje, said the GPHA was optimistic that the addition of national health insurance services at IMaH would help the facility to serve more people in the community.

The Board Chairperson of IMaH, Professor Gladys Amponsah, called for closer collaboration with the NHIA to ensure the smooth operations of the NHIS programme in the facility.