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NHIA sets up claims centre in Tamale

BY: Enoch Darfah Frimpong

Sylvester MensahA consolidated claims processing centre has been set up by  the National Health Insurance Authority (NHIA) in Tamale as part of its efforts to fast track the processing and payment of claims to major health facilities.

It will process claims from regional hospitals in the Northern, Upper East and Upper West regions as well as the Tamale Teaching Hospital.

The operations of the Tamale processing centre is to reduce pressure on the processing centre in Accra.

The Director of Operations at the NHIA, Mr Anthony Gingong, who announced this in Tamale at a training programme on medical terminology and disease coding organised for claims processing staff, finance officers and other personnel of the Tamale Teaching Hospital (TTH), said another centre was to be established in Cape Coast to handle claims in the Central Region.

Those initiatives, he explained, were intended to reduce the delays in the payment of claims and also bring an end to the intermittent denial of service by health facilities to clients of the National Health Insurance Scheme (NHIS).

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The purpose of the training was to equip the personnel with the requisite skills and competencies to code diseases based on the diagnoses of doctors and other medical staff so as to minimise the errors associated with claims processing.

The coding of diseases is the system used by the NHIA to calculate claims that accrue to health facilities that offer services to clients of the NHIS.

Mr Gingong said the NHIA had taken pragmatic steps to improve the operation and management of health insurance in Ghana.

The Chief Executive Officer (CEO) of the TTH, Dr Ken Sagoe, said the training would certainly impact positively on the operation of the NHIS, particularly at the TTH.

“After this training, we expect that there would be fewer mistakes in claims processing and it would ensure that payments due us are accurately calculated,” he said.

Dr Sagoe mentioned that flaws in claims processing had cost the hospital huge sums of money and revealed that the hospital lost an amount of GH¢1.2 million in 2011 and GH¢580,000 in 2012 as a result of inaccurate claims estimation.

“If we improve claims processing, it would increase our revenue because we would be paid what is due us,” he said.

Story: Nurudeen Salifu