The National Health Insurance Authority has commenced on-the-spot assessment of the level of compliance with the new directives on the one-hour deadline for the issuance of pre-authorisation code by Health Maintenance Organisations.
This comes into effect following the new guidelines introduced by the Director General and Chief Executive Officer of the agency, Dr. Kelechi Ohiri.
In line with the guidelines, facilities are mandated to continue with the provision of healthcare services to enrollees if pre-authorisation codes from HMOs are delayed beyond one hour.
In a statement on Saturday signed by the Acting Director, Media and Public Relations, Emmanuel Ononokpono, it said to measure and ensure compliance with the directive in the Federal Capital Territory, a NHIA Assessment/ Enforcement team conducted unscheduled visits to two prominent public hospitals in Abuja – the Federal Medical Centre Jabi and the National Hospital, Abuja.
It stated, “At the National Hospital, NHIA’s Ag. Director (Enforcement), Dr. Habib Abdulhamid, reported about 70 per cent compliance with the one-hour authorisation deadline. The team observed that some personnel of the facility involved in the request for authorisation code from HMOs were not conversant with the new directives, and further sensitisation on the steps to take towards providing services to enrollees was conducted. HMOs that were discovered to have flouted the deadline were also contacted on the spot.
“On his part, the NHIA Desk officer at the foremost hospital, Mr. Tony Osuji, told the team that measures have been put in place to reduce waiting time and bottlenecks associated with accessing care by NHIA patients in the hospital.
“At the Federal Medical Centre Jabi, the assessment indicated that the HMOs were in total compliance with the directive. A particular case discovered during the visit revealed that the facility had delayed in uploading their data following the HMO’s timely response to provide further information to assist in approving the request for authorisation”.
The statement concludes, “The NHIA is scheduled to continue monitoring the one-hour authorisation deadline by HMOs in other health facilities across the country in the coming weeks.”
Recall that in April, NHIA implemented a new directive aimed at reducing delays in accessing healthcare services and enhancing patient care.
To this end the authorisation of care and issuance of authorisation codes by Health Management Organisations shall no longer exceed one hour from the time of requests by providers, and healthcare facilities are to promptly submit requests for authorisation codes to HMOs to mitigate service access delays to enrollees. (With Agency Reports)
