Hospitals Raise Alarm Over NHIS Claims Delays
The Medical Superintendents’ Group of Ghana has raised concerns over disruptions in National Health Insurance Scheme (NHIS) claims processing following the migration from the Lightwave Health Information Management System (LHIMS) to the Ghana Health Information Management System (GHIMS), calling for urgent reforms to stabilise the platform and a review of tariffs to match rising healthcare costs.
The concerns were presented during a meeting between the newly elected leadership of the Group and the Executive Management of the National Health Insurance Authority (NHIA) in Accra. The engagement focused on challenges affecting healthcare providers and efforts to strengthen collaboration under the NHIS.
President of the Medical Superintendents’ Group, Dr. Eric Sarpong-Ntiamoah, acknowledged improvements in claims reimbursements but said the transition to GHIMS had created difficulties in submitting claims for services rendered in some facilities.
“We appreciate the efforts of the NHIA in ensuring timely reimbursement of claims. These payments have enabled health facilities to continue providing quality healthcare services to Ghanaians,” he said.
He noted that delays and system disruptions were placing financial strain on hospitals, which rely heavily on NHIS reimbursements to sustain operations. He further urged the Authority to address affected facilities while ongoing system challenges are resolved, and called for an urgent review of tariffs due to increasing costs of medicines, consumables and service delivery.
Responding, Chief Executive of the NHIA, Dr. Victor Asare Bampoe, acknowledged the challenges associated with the system migration and assured stakeholders that steps were being taken to resolve them.
He explained that proposals to compensate affected facilities based on historical claims had been considered and approved by the NHIA Governing Board, but could not be implemented due to restrictions under Public Financial Management regulations requiring verification of services rendered.
“We explored every available option because we understand the challenges providers are facing. However, we must ensure that any intervention complies with the Public Financial Management regulations,” he said.
Deputy Chief Executive for Finance and Investment, Madam Anatu Anne Seidu Bogobiri, reinforced the need for strict compliance with financial rules, stressing that payments must be backed by verifiable claims.
On tariff adjustments, Deputy Chief Executive for Operations, Dr. Kwesi Senanu Djokoto, said stakeholder consultations had been completed and a draft review was awaiting final approval. He acknowledged the financial pressure on providers and said work was ongoing to improve GHIMS stability.
The NHIA reaffirmed its commitment to strengthening collaboration with healthcare providers to improve claims management, enhance healthcare financing and support the delivery of quality services under the NHIS.
