NHIS reconciles N2bn unpaid claims by HMOs
The National Health Insurance Scheme (NHIS) says it has reconciled over N2 billion unpaid claims accrued by Health Maintenance Organisations (HMOs) for Healthcare Service Providers (HSPs).
NHIS General Manager, Enforcement Department, Mr. Muhammad Ghali, made this known while speaking with newsmen on the sidelines of a stakeholders’ forum on Tuesday in Kano.
Ghali said the amount was recovered by a special committee set up by the management of the scheme, sequel to complaints by the healthcare service providers over back-log payment of services rendered to its enrolees.
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He said that over N2 billion was recovered through reconciliation exercise conducted between June and July “Before the new management, led by Prof. Nasiru Sambo, NHIS recorded a lot of complaints by the healthcare service providers and it is subjecting our enrolees to hardship.
“When asked, they would say some other services that they rendered to the enrolees, the health maintenance organisations did not pay and this is coming to an unbearable level.
“So, the management came up with this principle of reconciliation whereby we collected all debts due to the HSPs within the period of 2019,” he said.
According to him, as at September, over N2 billion has been recovered from the Health Maintenance Organisations as payment to the health service providers.
“A letter of non-indebtedness was issued to the health maintenance organisations that completed payment of its debt.
“The exercise is still ongoing across the 36 states and FCT because there are some health maintenance organisations that are yet to complete payment,” he said.
The forum was organised to create awareness on the Group, Family, Individual (GIF-SHIP) programme initiated to mobilise participation in the scheme across the country.
Ghali said the forum was also designed to generate feedback from the stakeholders on how to fine-tune its programmes for effective service delivery.