The National Health Insurance Authority (NHIA) has begun evaluation at the point of the level of compliance with the new directives in the deadline of one hour for the issuance of the authorization code of authorization by health maintenance organizations (HMO).
Based on the new guidelines introduced by the NHIA under the leadership of Dr. Kelechi Ohiri, the facilities have the mandate to continue with the provision of health services for affiliates if the authorization code prior to the HMO is delayed beyond an hour.
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To measure and guarantee compliance with the Directive in the FCT, an evaluation/ application team of the NHIA made unchanged visits to two prominent public hospitals in Abuja: Federal Medical Center, Jabi and the National Hospital.
In the National Hospital, NHIA'S AG. The director (compliance), Dr. Habib Abdulhamid, reported around 70% compliance with the deadline for an hour authorization. The team observed that some staff of the installation involved in the authorization code application for the HMOs were not familiar with the new directives and a greater awareness was carried out in the steps to provide services to the affiliates.
For his part, Nhia's desktop officer in the most important hospital, Mr. Tony Osuji told the team that measures have been implemented to reduce waiting time and bottlenecks associated with access to care by NHIA patients in the hospital.
In the Federal Medical Center, the evaluation indicated that the HMO totally complied with the directive. A particular case discovered during the visit revealed that the installation had been delayed in loading its data after the timely response of the HMO to provide more information to help approve the authorization application.
Giving a general evaluation of the exercise, the director of the NHIA, the region of the center of the B del Norte, Dr. Chris Okoh, said that despite some of the discrepancies observed in some HMO operations in the National Hospital, there have been improvements in the response time to request the authorization code.
Speaking more about the importance of ensuring that the facilities always comply with the NHIA guidelines, Dr. Habib Abdulhamid expressed the authority of the authority to investigate some of the discrepancies observed by the team, while urging HMOs and medical care providers in the country to comply with the new policy directives to avoid facing the sanctions stipulated by the authority. He also declared that the NHIA will not hesitate to sanction any medical or wandering care center and advised those who do not comply with the guidelines to improve their performance.
The NHIA is expected to continue monitoring the authorization deadline for one hour per HMO in other health facilities throughout the country in the coming weeks.