By Joseph Erunke
National Health Insurance Scheme, NHIS,
ABUJA-THE National Health Insurance Scheme, NHIS, has released funds for payment of capitation and fee-for-service for its enrollees for the second quarter of 2020.
The agency, in a statement, Tuesday, by its Head, Media & Public Relations, Ayo Osinlu, explained that the action was “mong many other corporate initiatives to curb the rage of COVID-19 in the country.”
The immediate release of funds for the payment of capitation and fee-for-service for its enrollees for April to June 2020, it further explained, was to “guarantee uninterrupted access to healthcare services by enrolees of the Scheme in these challenging times.”
“By this timely action, NHIS has ensured that no enrolee will be turned back from any facility for non-payment of appropriate fees by any Health Maintenance Organisation (HMO),” it said.
According to the NHIS, “The Scheme took the step to ensure that the looming threat of COVID-19 is not compounded for the enrolees by the inability to access healthcare services at the points of need.”
“Responding further to the situation, NHIS has issued guidelines to the Healthcare Facilities (HCFs) and the Health Maintenance Organisations (HMOs) on certain actions to be taken towards protecting the interests of the enrollees in the current situation,” the said.
It read further: “These guidelines contain concrete provisions to prevent service failure, and also ensure that enrolees enjoy prompt and effective healthcare services despite general restrictions and outright lockdown in certain parts of the country.
“The guidelines gave clear order to healthcare providers to ensure the safety and protection of their personnel against COVID-19 infection, provide the timely and appropriate level of care for all NHIS enrolees as may be required, and ensure that no NHIS enrollee is denied access to care.
“It also directed the providers to note that all NHIS and HMO Call Centres are open 24hours daily. They are also to ensure the issuance of authorization codes and resolution of all other issues, ensure prompt reports of all cases of denial of authorization codes by HMOs, as well as maintain a high index of suspicion and promptly report suspected cases to NCDC or State Ministries of Health.
“On the other hand, the guidelines for the HMOs instructed them to also ensure the safety and protection of their personnel against COVID-19 infection, ensure prompt payment of capitation and fee-for-service to all healthcare facilities, while also ensuring the provision of the timely and appropriate level of care for all NHIS enrollees by the healthcare facilities.
“The HMOs are, by the guidelines, required to ensure that no NHIS enrolee is denied access to care, while their call centers are to be open 24hours daily, for prompt issuance of authorization codes and to resolve all other issues that may arise.
“They are equally directed to log all cases of issued or denied requests for authorization code by healthcare facilities.
“Meanwhile, NHIS will continue to closely monitor the situation and may revise the guidelines in the light of new developments.
“The Scheme has in the meantime advised all its stakeholders to adhere strictly to Local, State and Federal Public Health recommendations to curb the spread of COVID-19 in the country. ”