The National Health Insurance Authority will begin biometric verification of all patients who visit hospitals with their National Health Insurance card beginning in 2023.
Dr. Bernard Okoe Boye, chief executive of the National Health Insurance Authority (NHIA), who revealed this, explained that the move would help prevent underserved payments to hospitals that make claims when they have not provided the services for which they are demanding payment.
He made the remarks during a courtesy call to President Akufo-Addo by the NHIA’s board of directors and management to brief him on recent developments at the Authority.
“Next year we are going to have biometric verification. For these 19 years that we have been running the insurance, all the claims we pay, we pay in the dark in quotes, because hospitals give us documents that these people came to see us, we have no real time evidence that they were actually there, and we have had cases that have been prosecuted in court where claims were fraudulently generated,” Dr Okoe Boye said.
“Starting next year, we are going to, again, with the National Identification Authority (NIA) system, every Ghanaian, (it will be faced), when you go to the hospital, you will be biometrically verified before you are seen so that before the month ends, I know that Komfo Anokye saw to 5,000 patients. They [hospitals] can’t send me [NHIA] bills of 6000 people. That alone will cut out the fraud in the system,” the NHIA CEO stated.
Commenting on claims, he said “Your Excellency you told Ghanaians that [the NHIA claims management which was 10% electronic and 90% manual, you will turn it around and make it 90% electronic and 10% manual].
“I am happy to say that it was a 10% electronic system [and] within this time, we have gotten to 70% electronic management of the claims. And we are on course to get to 100% by the first half of next year (2023).
“Manual management of claims will be a thing of the past. Mr. President, this is very significant because 70% of all the monies that come to the fund are used in paying claims” Dr Okoe Boye said.
“If 70% of your fund is for paying claims, and you don’t have a very efficient system, it means that the wastage will be very huge, and I am happy to say that by first half of next year, latest by June next year, the story of manual claims management will be a thing of the past” he added.
President Akufo-Addo on his part commended the staff, management, and board of directors for their transformative agenda at the Authority.
He described as commendable the decision by the NHIA to use biometric verification in our hospitals.
“I think the biometric verification of patients is also another very important step in trying to give some rigor to the scheme so that as much as possible, claims [are] verifiable and in real-time not that you have to wait for hours for audits, etc. All of these are very important” President Akufo-Addo said.
“So, all I can say is, to all of you, from the chairman, through you, the chief executive, and members of the board the deputies, is to congratulate you on the work that you are doing on behalf of our country. It is important that government and the society in general, mobilizes as much as possible, to support the work that you’re doing” Akufo-Addo added.