Connect with us

Health

NHIS to give authorisation code if HMOs fail to give enrolees in 6 hours

Published

on

NHIS to give authorisation code if HMOs fail to give enrolees in 6 hours

Prof. Mohammed Sambo, the Executive Secretary, National Health Insurance Scheme (NHIS), says the scheme will give authorisation code directly to enrolees if Health Maintenance Organisations (HMOs) fail to give within six hours.


Sambo told the News Agency of Nigeria in Abuja that NHIS would issue the code to ameliorate the sufferings of enrolees (patients) if the HMOs could not issue the code within the hours.

He said NHIS had set up a committee to look into the complaints and delays in accessing authorisation code on time by HMOs.

He added that “the committee reported that we can ensure that within six hours, authorisation code is advanced to every client who requires it.

“And if HMOs fail to give authorisation code, we will ensure that we take over; NHIS will take over authorisation code to ameliorate the problems of enrolees.

“That is why we said we need healthcare professionals to achieve that.’’

The executive secretary said NHIS would have implemented the recommendation of the committee since January but was hindered by the lack of personnel to issue the code.

“In fact, we wanted to start by January but when we took inventory of our human resource at the state level, we realised that those compliment officials are not there.

“There are no doctors, there are no pharmacists in most of our state offices; there are no laboratory scientists who can quickly review and give you that authorisation code within the period of six hours.

“So what we are going to do is to ensure that we have the compliment of professions within our state offices.

“So that if there is a client in say Bayelsa and he or she requires authorisation code, and within six hours, HMO cannot provide, we will call the NHIS office to quickly review and issue authorisation code directly to clients.’’

According to him, if NHIS succeeds in issuing a code directly, it will deduct money from what it pays HMOs.

“This is what we are planning to do but we need to put our house in order to be able to achieve that.’’

Sambo also told NAN that there were other measures put in place to ensure that HMOs received payment in time to boost good service delivery.

“There are some immediate measures that we took; there are some remote measures that we also agreed to undertake to correct all these anomalies.

“Before Jan. 1, health maintenance reimbursement mechanisms were done on monthly basis, NHIS will pay the HMOs and then in turn pay the providers.

“This monthly payment is very huge. The administrative process is very huge for NHIS and is also huge for health maintenance organisations.

“We have changed the mode of payment to quarterly basis so that every quarter, we give HMOs the money based on the agreed rate of capitation and fee for service.

“They will now in turn ensure that before the beginning of every month, they pay the healthcare providers.

“We have started the intervention and so far, the reports we are receiving are encouraging, the providers are happy, the HMOs are happy, they are being paid.’’

In addition, he said, the scheme was making a lot of progress compared with previous years, saying “NHIS is getting stabilised and with stability, sky is not even our limit.’’

Edited By: Hadiza Mohammed-Aliyu (NAN)

Cecilia Ologunagba: is a graduate and a professionally trained journalist, with experience in national news reporting/editing and verification at the News Agency of Nigeria. NNN is a Nigerian online news portal that publishes breaking news in Nigeria, and across the world. Our journalists are honest, fair, accurate, thorough and courageous in gathering, reporting and interpreting news in the best interest of the public, because truth is the cornerstone of journalism and they strive diligently to ascertain the truth in every news report. Contact: editor[at]nnn.com.ng

Tanker drivers start strike Monday as talks with LASG end in deadlock NCDC confirms 437 new COVID-19 case, total of infection hits 46,577 Apapa will open to traffic in October — LASG Halep to decide on United States Open after Prague event Gov. Fayemi mourns ex-Ekiti lawmaker, Fakiyesi Vettel says Ferrari messed up with nonsensical strategy Ekiti Govt paying lip service to healthcare delivery, say striking doctors Resumption: Academy wants COVID-19 protocol funds released directly to schools Willian confirms exit from Chelsea after 7 years Anglican Bishop urges govts to save SMEs from collapse For Europe’s “super clubs”, UEFA Champions League determines all YYA sues for peace in Ondo Assembly, condoles with Ogun over Kashamu Ilorin communities appeal to Gov. AbdulRazaq over damaged culvert NPFL 2019/2020 season: Rivers United still insisting they finished second, not third Imo Assembly restates commitment to local production through effective legislation CAN President urges FG to overhaul security apparatus  Osun: Police dismiss inspector for allegedly brutalising tailor, causing death Nimet predicts cloudy, thundery weather activities Monday to Wednesday Sanwo-Olu gives hospital’s management 7-day ultimatum to remove trucks, containers FG supports Imo farmers with 20,000 cocoa seedlings, other improved seeds COVID-19: Low attendance, strict compliance greet church re-opening in Lagos Ex-Rep wants Obaseki impeached over alleged breach of constitution NMA charges state branches to uphold values to protect members Unknown assailants kill Gov. Obiano’s aide on security DG APC Governors Forum tasks membership on participation, registration  Banditry: Monarch urges govt. to adopt new strategies Cleric tasks worshipers on COVID-19 guidelines as church services resume Kwara records 7 new cases of COVID-19 Beauty queen pledges to showcase cultural heritage of Northern Nigeria Zamfara agency sensitises communities on World Bank projects maintenance, sustainability Don’t smoke away your babies, Gynaecologist warns PDP BOT Chairman seeks conduct of LG election by INEC Community policing: FCT minister advocates involvement of council chairmen, traditional rulers Former Police boss blames security challenges on corruption, bad governance Southern Kaduna attacks: Coalition tasks locals on credible information to military Delta communities want FG to revive abandoned projects Dabiri-Erewa says Dapo William’s death great loss to Nigeria Rev Okoye urges Nigerians to return to God, shun tribalism, other vices Commission pledges to eradicate illiteracy, poverty in North-East FG, ECOWAS to host biodiversity consultation on environmental protection Journalists Forum uncovers Nigerians in critical situation in Saudi Arabia NOA urges collaboration of traditional leaders in fight against COVID-19 APC in UK pays tributes to late Dapo Williams Ekiti Govt distributes protective materials ahead Monday’s school reopening Kogi govt extends schools’ fumigation to Eastern Senatorial district Buhari mourns UK-based Nigerian, Dapo Williams COVID-19: Mosques in Ekiti ready for reopening – NSCIA COVID-19: Churches in Lagos  reopen, record  low turn out after 20 weeks of lockdown Church re-opening: Cleric wants leaders ensure compliance with COVID-19 guidelines FCTA pledges support to Suleja smart city project