The Dormaa Central Municipal Manager of the National Health Insurance Authority (NHIA), Eric Yeboah Kyeremeh, has identified illegal charges and co-payment by some healthcare providers as major challenges undermining the effective implementation of the National Health Insurance Scheme (NHIS).
Speaking to Gifts FM News, Hon. Kyeremeh said some health facilities continued to charge NHIS cardholders for services covered by the scheme, despite improvements in claims payments and increases in tariffs.
He urged NHIS members to demand receipts whenever they were charged for treatment, explaining that the receipts would serve as evidence to support investigations and possible sanctions against facilities found to have violated the scheme’s guidelines.
Mr. Kyeremeh attributed the prevalence of co-payment in the past partly to delays in claims payments and low tariffs, which he said placed pressure on healthcare providers. He maintained that improved tariffs and prompt claims payments under the current NDC government should help address the situation.
He further explained that healthcare facilities operated under specific credentials that determined the medicines and services they were authorised to provide under the scheme. He encouraged facilities that had upgraded their equipment and service capacity to apply for a review of their credentials to enable them to offer additional services.
The municipal manager appealed to healthcare providers to cooperate with the NHIA and comply with the scheme’s guidelines to ensure that members received quality and affordable healthcare without being subjected to unauthorised charges.
He also encouraged NHIS members to report suspected illegal charges and provide relevant evidence to help the authority investigate complaints and enforce compliance among healthcare providers.
Eric Yeboah. Kyeremeh said cooperation between the NHIA, healthcare providers and members remained essential to protecting the interests of subscribers and ensuring that the scheme delivered its intended benefits.
Source: Kwaku Mensah Abrampa, Gifts FM, Dormaa Ahenkro.
