Hopes are dashed for National Health Insurance card holders in the Ashanti Region who are turning to government facilities for healthcare services as mission hospitals insist on payment upfront. Nearby public health facilities, under the current situation, accept health insurance only for emergency cases. Under capitation, service providers do not recognize unregistered primary out-patients, and therefore demand cash payment from them. The Health Insurance Authority on Tuesday directed NHIS card bearing patients denied services to visit government hospitals or use accredited NHIS outlets. But that directive has hit a snag as public facilities demand cash before attending to out-patients. They say they cannot treat such conditions as emergencies as announced by the NHIA. Nhyira News checks reveal several patients have since Monday been knocking at the doors of nearby public hospitals for care only to be asked to pay cash. The public hospitals include Suntreso Government Hospital, Komfo Anokye Teaching Hospital and the Kwabre District Hospital at Mamponteng. Medical Superintendent at Suntreso Government Hospital, Dr. Kwabena Opoku-Adusei told Nhyira FM the best care they can provide on NHIS is emergency cases. “If it is emergency and then your disease is diagnostic-related, I can see you and I can present my bills. If it is only OPD, in technical terms, if you have capitated or your primary preferred service provider is SDA Hospital or a CHAG institution and you come to my institution, I cannot see you because your money has been deposited with SDA or with the CHAG institution or private practitioner that you yourself has taken as your primary preferred provider. So if I want to be fair with you and the system, I also demand that you pay money upfront”. Dr. Opoku-Adusei explained. Some private facilities were first to suspend NHIS services in the heat of the introduction of the capitation program. The Ashanti region has a total of 530 health institutions which the Ghana Health Services controls only 32 per cent with 170 government health facilities. The rest are 71 mission and 281 private institutions. Dr. Opoku-Adusei who is also President of the Ghana Medical Association called on the NHIA to pay all outstanding claims owed health institutions to enable them operate fully. “NHIA themselves advertised that they owe facilities from September last year and I am telling you that as at last week , they were owing me( Suntreso Government hospital) from August, half of August and they are owing so many institutions. Meanwhile, some government health facilities in the region are thinking about suspending NHIS services. Managers of these facilities though will not speak on record say the move has become necessary due to the hardships associated with the current payment system at NHIA. The situation, they say has compelled managements to cancel some packages which hitherto were enjoyed by staff as a result of lack of funds.