The National Health Insurance Authority, NHIA, has cautioned against what it said are “unfounded statements” being peddled in the media. Eric Ametor-Quarmyne, Deputy Director, Strategy and Corporate Affairs, in a press release said such statements tend to undermine public confidence in the National Health Insurance Scheme on which millions of cedis are spent annually to provide ‘free’ access to healthcare for the rich and the poor in the country. “One such unfounded statement was a claim by the Chief Pharmacist of the Cocoa Clinic in Accra, Mr. Edward O. Amporful that a number of service providers are in arrears for non-payment of claims submitted to the NHIA for over six months published in the 28th September, 2010 edition of ‘The Ghanaian Times’ in a feature article.” “The NHIA wishes to state that no District Mutual Health Insurance Scheme owes any Provider including the Cocoa Clinic six months of unpaid claims.” He said Mr Amporful’s article was published just a day after the President of the Ghana Medical Association; Dr. E. Adom Winful told the media that there has been remarkable improvement in the services of the National Health Insurance Scheme and hoped the trend would continue. “The National Health Insurance Authority wishes to commend the President of GMA for his honest observation and to challenge the Chief Pharmacist of the Cocoa Clinic in Accra to publish the list of all service providers who’s NHIS Claims are in areas of six months. The NHIA would be grateful to Mr. Amporful for this assistance in order to correct any shortfalls in payment to service providers who form an important segment of the healthcare system.” According to the statement, the Cocoa Clinic’s own Claims Officer, Prince David Tawiah, admitted the following facts when the Authority contacted him over the state of reimbursements between the Cocoa Clinic and the Okaikoi Scheme which deals directly with it:

That the Clinic submitted its June NHIS claims to the Scheme on the 21st of July, 2010, which is two months ago and not six months ago.

That the Clinic submitted its July NHIS claims to the scheme on the 1st of September, which is this month, and not six months ago.

That both claims have not yet exhausted the 90 days statutory period for settlement.

“The Chief Pharmacist of the Cocoa Clinic knows that by law it takes three months to submit, process, and pay NHIS Claims to providers. In the past, some claims payment got delayed beyond the three months for reasons of lack of finance, or that the claim was contentious or that the claim was submitted late. “Since the beginning of this year, 2010, the NHIA has made financial releases to Schemes for the prompt payment of providers throughout the country. The releases made to the schemes for payment to providers were published in the Daily Graphic and the Ghanaian Times and invited any provider that did not receive payment to report to the Authority. “Not a single provider including the Cocoa Clinic has reported to the Authority that it has not received payment promptly. So where is the truth of the claim by the Chief Pharmacist of Cocoa Clinic that the Scheme owes providers six months arrears in claims?” the statement enquired. “The National Health Insurance Authority again wishes to invite all stakeholders especially Service Providers and the media to help build public confidence in the National Health Insurance Scheme by cross-checking their facts with the Authority before rushing to publish unfounded statements. As a public institution our doors are always widely opened for such interactions.” Story by Myjoyonline.com/Ghana