NHIA Launches Online Claims Platform

Nathaniel Otto,  NHIA

The National Health Insurance Authority (NHIA) has launched a free online platform for service providers to submit their claim electronically to the claims processing centres.

The commencement of the new platform – Claim-It– is expected to eliminate the cost of claims forms, human resource and cost of transportation of claims, thereby, ensuring efficiency and effectiveness in claims processing.

The Claim-It application which will soon be made available to all NHIA service providers across the country comprises a claims entry module, a receiving system, a claims adjudication module and regional and district health director reporting module.

Nathaniel Otto, Chief Executive Officer (CEO) of NHIA, expressed his gratitude to the team that developed the platform, indicating that the NHIA has tried to make life easier for subscribers and providers of the NHIA to make their experiences better.

He mentioned that claims management is the core of their business, taking close to about 80 percent business and must, therefore, ensure that whatever funds the authority releases is justified. Explaining the process to participants, he said, “The claim entry module implements and enforces all the necessary claims generation rules and protocols of the NHIA.”

Mr Otto stated that the new portal also ensures the validation of claims presented for adjudication by the application and ensures due diligence prior to claims submission.

“The provider end module runs fully offline and will allow users to work independently without internet. It can be installed and operated on a singular user computer or implemented as a network application with as many user as needed,” he said.

He explained that the authority envisages substantial benefits from wide scale adoption of Claim-It, including the reduction of claims generation errors and inconsistencies, improved claims processing time and reduction of the cost of claims storage for both NHIA and health providers.

“We also anticipate that going forward when other systems are built to support our internal processes, providers will be able to track their claims during vetting and adjudication process which should remove the bottle necks related to claims,” the NHIA CEO added.

Dr Ebenezer Appiah Denkyirah, Director General of the Ghana Health Service (GHS), in his remarks was delighted about the establishment of the platform which gives access to district and regional health directors to view claims by health facilities under their jurisdictions.

He said Claim-It would assist the GHS with data for planning and health interventions as the various district directors would have access to the portal summary and report.

BY Jamila Akweley Okertchiri