NHIF refutes delaying claims payment

ASHERY MKAMA

THE National Health Insurance Fund (NHIF) has denied claims by some health services providers, particularly government institutions that the Fund has become an obstacle due to delays in paying claims.

Some claims presented to NHIF have been plagued by massive fraud which makes it to take long verifying them, including contacting patients, by phone, who would have received medical treatment.

NHIF Acting Director General, Michael Mhando said some health services providers are reluctant to use the electronic system which simplifies verification process and providing fraud control.

“Other claims which have been presented to us contain irregularities, including lack of necessary information which causes NHIF to delay payment because such claims are unpayable,” Mhando said.

He was speaking to reporters in Dar es Salaam yesterday over claims by health services providers and insisted that NHIF’s role is to timely pay them their claims according to law and regulations.

“This information creates a negative perception that NHIF is an obstacle regarding to effectiveness of those health centres which is not true and contains the images that cause hatred between NHIF and the public in general,” Mr Mhando noted.

He said NHIF has taken such steps and implemented an order from President John Magufuli in his speech when opening the 11th Parliament in Dodoma last week to ensure that hospitals, health centres must improve service provision to patients due to existing challenges facing the health sector.

He insisted that NHIF among other strategies has made various efforts to ensure it works closer with the government in improving health centres by introducing training in workplaces and encourage health providers to submit their claims on time so that they can be paid timely.

He reminded and insisted that NHIF has its mechanism of providing medicine loans, medical supplies, and rehabilitation of buildings and infrastructure of ICT to improve medical services in centres where 10 billion shillings has been allocated for that purpose.

Currently, NHIF has registered 6,347 health centres countrywide which offer medical services to its members. Apart from private sector, public institutions and religious organizations, the fund has also registered all state facilities from the level of dispensary to Muhimbili National Hospital (MNH).