NHIA saves state GHS10.6 million in claims processing

By Albert Futukpor 

Tamale, Feb 28, GNA – The National Health Insurance Authority (NHIA), has saved the state an amount of GHS10.6 million after rigorously assessing and reviewing claims submitted to it by health care service providers. 

The savings were made in the year 2022 in the Northern, North East, Savannah, Upper East and Upper West Regions, Mr Isaac Akonde, Deputy Director in-charge of Claims at the Claims Processing Centre, NHIA, Tamale, who announced this at the Northern Regional annual performance review meeting of the NHIA in Tamale, said this was after a very rigorous assessment and review of the claims submitted to the NHIA for payment. 

The two-day event, which was to take stock of the operational activities of the NHIA in the region for the year 2022, also coincided with the training on leadership for the directors of the NHIA in the region to enable them to lead their teams to achieve their set targets for the year. 

Mr Akonde said through the assessment and review of the claims, it was realised that some medicines provided did not match the diagnoses of patients amongst other errors leading to deductions from the claims being sought resulting in saving the state that amount. 

During the year under review (2022), the value of claims processed by the NHIA in the five regions in the north was GHS145,508,829.68 out of which GHS10,682.225.25 deductions or savings were made. 

Mr Akonde encouraged service providers to enroll onto the electronic system of submitting their claims to the NHIA to ensure that they corrected all the necessary errors before submitting their claims, adding the use of the electronic system would also reduce the cost-of-service providers. 

Mr Abdul Latif Issahaque, Northern Regional Director of NHIA, gave an overview of the population registered under the National Health Insurance Scheme (NHIS) saying “Over the last three years, the region has witnessed an increase in its active membership on the NHIS. In the year 2020, with an estimated population of about 1,811,115 people, and given a target to register and keep active 996,113 people, the region registered 964,800people, representing96.9 per centof the target. 

Mr Issahaque added that “In 2021, the target was increased to 1,317,238 with a projected population of 2,310,939 people.  

“The region registered 940,882 representing 71.4per cent of the target set. By the close of year 2022, with an estimated population of 2,359,469 people, the region was able to register about 1,031,307 people. Thus, achieving about 87.4 per cent of the target set for the region. This translates into increasing by 16 per cent of what was achieved in 2021.” 

He said “Of this total active people, all children under 18 years, who were registered, were about 423, 924 representing 41.1 per cent of the total membership; Adult Informal members were 244,352 people, representing 23.7 per cent of the membership. The core poor/indigenes captured were about 211,611 representing about 20.5 per cent of our enrolled membership in the region.” 

He spoke about the registration of indigenes saying “In 2020, the region registered 146,199people under this category. In 2021, the region increased this figure to 197,906 people. The region, with its continuous dedication to capture the poor and marginalised in society, has again increased the number of indigenes registered to about 211,611 achieving about 119.6 per cent of the target given to it.” 

Mr Issahaque indicated that concerning active membership, “In the year 2020, out of the total active membership of 964,691, over 301,484renewed their membership, and thus became active through the mobile renewal system. By the close of the year 2021, the number of people, who renewed their cards using the Membership Mobile Renewal Service increased to 319,829.  

“This has further increased to 342,537 people, who have remained active members using the Mobile Renewal Platform.” 

He assured the public that the NHIA would continue to work to nib in the bud all matters of reported illegal charges at the various health facilities across the region urging the public to report all suspected illegal charges. 

Mr Tibis Sory, Director, Northern Belt, NHIA, commended the Northern Regional office of the Authority for its hard work, saying he was overly impressed with the performance of the region especially in number of people registered under the scheme and the active members. 

He expressed the need for the people to champion the efforts aimed at eliminating illegal claims to make the NHIS sustainable. 

GNA