By Samwel Doe Ouma @samweldoe
The National Hospital Insurance Fund (NHIF) has developed an E- Claim system to minimize fraud in the claims processes. According to Geoffrey Mwangi, NHIF’s Chief Executive Officer, the Electronics Claims system will do away with the current manual system and replace it with an efficient, faster and convenient on -line system that will eliminate fraud across the institution’s supply chain.
Already, the new system has been rolled out across 500 health facilities in Nairobi, with plans to roll out to other hospitals countrywide by the end of September. “Going forward, all our accredited hospitals will now interface with our systems and will be able to make their claims through the electronic system. We will then make the payments electronically from our end, minimizing time wastage and fraud,” said Mr. Mwangi.
Mr. Mwangi said the new synergy between NHIF and health providers in tracking claims through the system will be faster and easier to handle from a computerized environment, compared to the earlier manual system.
Further, to increase accessibility to services, Mwangi said NHIF had so far accredited 7,800 facilities with 67 percent of these being public health institutions with 21 percent private and 4 percent mission hospitals. Mr. Mwangi said NHIF had developed a Comprehensive Medical Insurance Cover in a bid to achieve the set out targets in the Universal health coverage plan of ensuring every Kenyan has access to affordable medical cover.
According to Mr. Mwangi NHIF is enhancing package to ensure that people get access to quality and affordable care. “NHIF is re-engineering to improve service delivery through electronic health management system. For the premium charged, members can access an enhanced benefit package that includes; inpatient services, outpatient services, local ambulance services, emergency air rescue, laboratory and X-ray services, optical cover, maternity cover, dental cover, substance abuse and rehabilitation, diabetes, renal dialysis, cancer treatment and last expense and group life cover.
Mr Mwangi said that NHIF key achievements include the expanded benefits package tailor made to meet member’s needs; biometric registration, electronic claims processing, implementation of Linda Mama for expectant mothers and launch of the customer relationship management system. NHIF is currently on the drive to register many members to expand quality of care.
