NHIA initiates open policy on claims payment – Dr. Okoe Boye

The National Health Insurance Authority (NHIA) has implemented a new policy aimed at enhancing transparency and efficiency in claims payment process and keeping stakeholders informed.

Leading the NHIA, announced the initiation of a digital payment system, allowing service providers to electronically submit claims for vetting and payment within a 90-day period, as mandated by law.

Currently, over 95% of claims are submitted electronically, significantly reducing delays in processing and ensuring timely payments to healthcare service providers.

This initiative aligns with the NHIA’s commitment to providing seamless access to healthcare for its members.

In addition to the digital payment system, the NHIA has introduced the “Sunshine Policy” under Dr. Okoe Boye’s leadership.

This policy aims to enhance transparency by updating stakeholders on the payment status of claims made to healthcare providers affiliated with the NHIS.

Described as the missing piece in the healthcare financing puzzle by stakeholders, the Sunshine Policy enables the public and other stakeholders to check online for information on claims payments made by the NHIA.

The platform allows users to identify which facilities received payments, the amounts, and the corresponding month(s) for the disbursements.

The filter system categorizes providers as either public or private.

Speaking at the Ghana Medical Association (GMA) summit, Dr. Okoe Boye emphasized the importance of service providers diligently serving clients and subscribers without imposing illegal charges on patients under the Scheme.

He highlighted that the NHIA fulfills its financial obligations by disbursing not less than GH₵100 million to service providers monthly, urging providers to reciprocate by upholding their responsibilities to maintain confidence in the Scheme.

Dr. Okoe Boye stated that the policy’s intention is to bring transparency to NHIA payments and stimulate honest discussions on health financing in Ghana.

Under the leadership of Dr. Okoe Boye, the NHIA continues to implement initiatives aimed at inclusivity and transparency, with a commitment to advancing the healthcare ecosystem in Ghana.

Dr. Okoe Boye marked his presence at the 65th GMA anniversary in Takoradi, demonstrating his dedication to keeping the medical community updated on the NHIA’s progress.

To access the Sunshine Policy, stakeholders can visit the NHIA website (www.nhis.gov.gh).