Mr. Foster Agyei-Korang, Brong Ahafo Regional Manager, National Health Insurance Scheme (NHIS), on Tuesday appealed to operators in the region to ensure regular and prompt monthly payment of monies due to client service providers for efficient and reliable performance.
He asked operators not to allow huge sums of money "to sit" in their accounts whilst service providers were unpaid to avoid being queried by the authorities, saying the practice "defeats the NHIS main objective of providing quality and affordable healthcare for all".
Mr. Agyei-Korang who was speaking in Sunyani at the third quarterly review meeting of the Sunyani Municipal Mutual Health Insurance Scheme, said the quantum of available amount, "no matter how small it is" should not deter operators from making regular payments to service providers.
The Regional Manager, however, urged service providers "to be reasonable with operators and accept whatever is offered at any period since half a loaf is better than none". He explained that such little sums would generally sustain operations of the scheme which better than a situation where service providers would be cash-strapped and consequently close down.
The inability or refusal of service providers to attend to the sick as a result of non-settlement of bills by operators posed a big threat to the sustenance and survival of the NHIS, Mr. Agyei-Korang said.
He explained that whilst staff of the scheme performed as managers of the programme, the actual and practical realization of the scheme's objectives and goals rested on the hospitals and clinics so long as they remained in business.
Mr. Isaac Afari, Manager of the Sunyani Municipal Scheme, said the process of discussion with health service providers after vetting of their claims was aimed at reducing the "filing of questionable bills" but that notwithstanding most of them continued to present outrageous bills, he noted. From January to June this year, the Sunyani scheme detected anomalies of claims to the tune of GHC 128,838.95, the Municipal Manager added.
He said there were bottlenecks that if not tackled would not only erode "the good reputation" they had gained over the years but could also result in the collapse of the entire programme.
He cited that instances of "providers prescribing drugs outside the medicine list and pharmaceutical and chemical shops asking clients to do top-ups" as acts bothering on dishonesty and criminality and appealed to both health providers and clients to resist that temptation to save the scheme from grounding to a halt.
The Municipal Manager identified escalating increase in monthly medical bills the scheme received from health service providers also as "a major threat to the scheme's sustainability", saying "there has been a sharp increment in bills for the past nine months and something should be done to reduce the rate". The sustainability of the scheme largely depends on the providers and "we must all be committed to device strategies that would help to reduce medical bills to the scheme considerably", he emphasized.
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