NHIA Capitation in Limbo

Health service providers and pharmacists in the Volta, Upper East and Upper West regions are crying foul ahead of plans by the National Health Insurance Authority (NHIA) to roll out the capitation system of claims in the regions.

The decision by NHIA has ignited fears among service providers on issues relating to non-commensurate amounts and delays in claim payments raised in the Ashanti region and fear this could be replicated up North.

Speaking to Ultimate news the President of the Upper East branch of the Private Health Care Providers Association of Ghana; Dr. Francis Asaana demanded the NHIA to pay them up front for monies owed in the past before they render services to patients.

‘We have seen capitation in the Ashanti region and the challenges were enormous. What we do is to present the claims and payments are made, but now we are saying that all arrears must be paid before they enrol capitation. Pay us upfront for us to see patients before the onset of capitation’.

According to him, they have not been paid for 6 to 8 months in the Upper East.

‘Capitation is a different system, we signed an Memorandum of Understanding (MoU) where we adopt to the old system to provide treatment to clients and present claims for payments, since capitation is a new system altogether, we are unable to stop services which make us apprehensive,’ he asserted.

The Communications Director of NHIA, Dr. Adjetey Annan who however expressed satisfaction in the improvements of the scheme, assured that they will pay all arrears in the three regions.

Dr. Annan assured that the NHIA has learnt lessons from the pilot project in the Ashanti region, saying measures have been put in place to ensure that the extension in the three regions become a success.

He admitted that more people have subscribed to the system and that has resulted in the funding gap, adding that their expenditure exceeds their income but funding will be made to clear the gap.

According to him, they try as much as possible to make payments and that money is flowing into service providers’ accounts.

By:Ultimate1069.com/Ghana/Leticia Osei