NHIS to verify claims through biometric system

BY: Enoch Darfah Frimpong

The National Health Insurance Authority (NHIA) will, from May this year, begin verifying claims from its service providers through a biometric system to reduce fraud.

The system will capture the biometric data of NHIS cardholders and generate a claim code the moment the cardholder visits any health facility providing service for the health insurance subscribers.

The Director of Administration and General Counsel of the NHIA, Mr Nathaniel Otoo, said the move would help reduce fraudulent claims by some of the service providers.

According to him, no health facility would be paid its claims if patients who used that facility did not go through the biometric system.

He was speaking at a high-level meeting on sustainable healthcare financing for Ghana in Accra yesterday.

The event, which was organised by the Universal Access to Healthcare Campaign and attracted civil society organisations and health experts, was to deliberate on how to develop an effective financingmechanism for health care in Ghana.

Mr Otoo said besides that, the NHIA would also roll out a mobile money payment system to remove cases of intermediaries receiving premiums in addition to a single premium account to prevent the situation where schemes kept premiums.

He noted that while the NHIA played its role, it was important for all Ghanaians to safeguard the scheme against abuse.

With about 22 million registered members and 8.6 million active users, premium is said to contribute less than 15 per cent of funds to the NHIA, hence calls for the scrapping of the premium.

That, Mr Otoo said, was not feasible, as the scheme needed additional sources of finance to ensure the sustainability of the scheme.

Interestingly, premium from the informal sector has not exceeded five per cent of the total income of the NHIA over the years, with the other sources of funding filling the remaining five per cent gap.

That, Prof. Agyeman Badu Akosa, a former Director-General of the Ghana Health Service, said was not enough to sustain the scheme.

To improve funding for the scheme, he mentioned a percentage of property tax collected by the district assemblies, environment tax from mining companies, a percentage of Driver and Vehicle Licensing Authority (DVLA) fees as possible sources of funds for the scheme.

He took issue with the NHIA spending money to build a national head office and regional offices, instead of capital investment.

While warning that the collapse of the NHIS would lead to a collapse of the health sector, he also stated that he would fight any attempt to increase the NHIL.

He proposed a flat GH¢10 premium which he said could ensure that the NHIA raised GH¢91 million from premiums alone, instead of the current GH¢28 million.

The Executive Director of SEND-GHANA, added his voice to the call to increase the funding sources to include tax from the petro-chemical industry, the forestry sector and property rates.

Story: Seth J. Bokpe