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“We Are Working On How To Halt Illegal Payment” - Dr. Lydia Baaba Dsane-Selby Hints

The Chief Executive Officer (CEO) of the National Health Insurance Authority (NHIA), Dr. Lydia Baaba Dsane-Selby has hinted that her outfit is working tirelessly to deal with the activities of illegal payments by patients to health officials at some health centers across the country.

According to her, the NHIA has call centers that are ready to do follow-ups on reports of illegal payments and take back monies paid.

Addressing Journalists in Accra, she said “On illegal payment, we have a call center, those who call, we follow up at the facility and we have been able to take the money back and give it back to the person quite a few times but what we find is patients are very reluctant to report perceived wrongdoings at health facilities. We all know what we feel about a hospital and health care, you never know when your turn will come so people feel very reluctant to report but the few who do, we are able to get their money back. We are working on what we can do to halt illegal payment”

She also hinted those patients who visit health centers should devoid of being reluctant when they observe or fall victims to such illegal activities.

The CEO also hinted that her outfit has a policy that ensures that if people default by more than three (3) months after renewal, they serve a month's waiting period.

“I think that is the policy in most Insurance Systems. Only people who are exempted from that are pregnant women and children under five (5). We all know that children under five (5) can be seriously ill sometimes in the space of an hour and we can’t afford to wait and obviously for pregnant women, it is free and we need to get them treated. Everybody else will serve a one (1) month waiting period and our system is hard-wired, you can’t pay somebody within NHIA to takeaway that unless they register you as a pregnant woman or a child under five (5)” she noted.

Dr. Dsane-Selby also revealed that a few have tried but her outfit managed to arrest the staff of which they have been sanctioned.

Speaking on the synergy of the Ghana Card and the NHIS card, she said “At our NHIA launch last year, we publicized the seven steps to link your Ghana card to your NHIS if you have one already. The challenge is people have different names, different dates of births, and all sorts, so the 5 or 6 key indicators are completely different between the two cards they are holding. So only about 100,000 people who have been able to do the link by mobile phone themselves”

She revealed that her outfit is piloting in four districts in Accra adding that if people visit the office and get the link done, they can be able to use their Ghana card afterward.

“I know the hospitals have been trained to accept the Ghana card in all the clinics. It’s the same mobile technology that they will use to authenticate you when you go there. It’s the same *929# and then you follow the seven steps which will link the two cards”

Speaking on pre-auditing, she revealed that the NHIA has claims processing centers that look at all submitted claims.

“Obviously, if you submit it electronically, we have some level of Artificial Intelligence that does a lot of the vetting. If it manual then, unfortunately, our staff have to manually go through. That is why we give ourselves two months from the date of submission to be able to pay the claims.”

On her part, the Chief Executive Officer (CEO) of the National Blood Service (NBS), Dr. Justina K. Ansah said “We as a country are not self-sufficient for blood, we need just 1% of the population to donate blood so we will be sufficient but we realized that our blood collection per index is 5, meaning instead of 10 people, we get only 5”

She mentioned adequacy as one of the problems adding that it has contributed to the NBS not having lots of voluntary donors.

“Covid really affected us. As of 2019, voluntary donations were 33% and at the end of 2020, it was 17% which is very bad. What could have happened is that there was no blood available or the blood group needed for that person was not them because we need to have all the blood groups available at every time” she said.

She later appealed to the public to voluntarily donate blood to help save the lives of persons in need.

“So my appeal is that we are doing a lot of education to get people between 17 to 60 to donate but people who cannot donate, you can have advocates, people to donate and I think that if we all put our hands to the plow, we will have enough of the blood groups so that if anyone wants blood, it will be available” Dr. Justina K. Ansah concluded.

Below is a video:

Story by: Joshua Kwabena Smith


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