The Upper East Region National Health Insurance Authority (NHIA) achieved 63 per cent of its mid-year membership target of 338,882 as at the end of June.
Mr. Sebastian Alagpulinsa, the Regional Director of the NHIA, announced that districts such as Bawku Municipal, Bolgatanga Municipal and the Talensi-Nabdam satellite office, also achieved beyond 70 per cent of their membership targets.
He made these disclosures at the 2015 mid-year performance review meeting in Bolgatanga.
The review meeting was designed to create a platform for the managers of the NHIA to identify the scheme’s operational gaps and best practices with the view to forging ahead to drive home the sustainability of the NHIA.
Mr. Alagpulinsa said currently the district offices were more aggressively positioned and capturing school children and the indigent groups as well as the vulnerable ones across the region to ensure that all targets were met by the end of the year.
“I must place on record that there will be no justification for a district office in this region to fail to deliver on its membership target, especially on the poor and the vulnerable by the end of the year since the region is a noted poor region,” he said.
He said all those membership arrangements were under the Biometric Registration Systems of which Identity Cards (ID) were issued instantly.
According to him, the biometric system was meant to enhance data integrity and credibility and to avoid instances of double registration and duplication of membership data.
In effect, clients’ biometric data will be verified before treatment at the facilities, which will help check some of the “moral hazards” such as claims recycling and double billing, which are potential threats to the sustainability of the insurance scheme”, he emphasised.
Mr. Alagpulinsa said the NHIA was facing transportation and office accommodation challenges, adding that some district offices’ vehicles were over-aged and needed replacement.
He said the Authority provided new vehicles to the Builsa, Navrongo and Bawku Municipal offices during the first quarter of 2015 and was optimistic that other district offices would be provided with new vehicles by the end of the year 2015.
According to him, the issue of building district offices had been on the drawing board and even some processes had started and it was the wish of the Authority that all district offices were provided with decent office accommodation.
Dr. J. Koku Awoonor-Williams, the Regional Director, Ghana Health Service, on his part, expressed concern that clinical audit decisions were quite unilateral and that most often the service provider and client were not involved in most of the discussions at the NHIA.
He said there was lack of transparency and co-ordination in the operations of the NHIA.
Dr. Awoonor-Williams noted that efforts had been made to reduce the period of the processing of claims but to no avail.
He said there were still huge gaps with regards to the rejection of claims based on errors, fraud, abuses and over-prescription, among others without given room for any arbitration.
SOURCE: the ghanaian times