• Services on Friday were disrupted over what the national insurer termed a disruption due to a critical power fault occasioned by a faulty transformer.
•The Ministry of health directed that all claims management processes be done digitally through the E-Claim platform.
Image: FILE
The NHIF has resorted to manual processes for clearing claims from patients to ensure continuity of services in hospitals.
This is after services on Friday were disrupted over what the national insurer termed a disruption due to a critical power fault occasioned by a faulty transformer.
The disruption has seen hundreds of patients stranded in various health facilities as they are unable to access NHIF payment services.
The majority of those affected are patients who have been discharged and have to clear their pending bills using their NHIF cover.
NHIF said the power outage has caused system downtime since Friday morning and technical teams are working round the clock to restore services to normalcy.
“In the meantime, the public has been notified that alternative manual processes have been implemented to ensure uninterrupted services while seeking treatment in hospitals,” NHIF said in a statement on Saturday.
“Further, NHIF has communicated to all hospitals to ensure patients are not denied services or asked to pay for services that NHIF covers.”
The downtime has forced some of the affected patients to stay longer at the various health facilities to await services to be restored.
It remains unclear how long it will take for normalcy to be restored. The collapse of the system has also affected mobile services since members are unable to make their monthly contributions.
In June last year, the national health insurer embarked on a mass biometric registration system for its members, as well as an electronic claims management system for all NHIF contracted hospitals.
The E-claim connectivity covers accredited healthcare facilities in KEPH levels IV to VI government facilities and all faith-based and private facilities.
Once registered, the facilities are required to switch from manual to electronic submission of claims in a move expected to improve efficiency and reduce fraud, wastage and abuse.
“As a government, we are keen to ensure that the insurance claims management processes are made as efficient as possible,” Health PS Susan Mochache said at a past function.
The Ministry of Health directed that all claims management processes be done digitally through the E-Claim platform.
“We will ensure that the claims management process is fully digitised to end perennial challenges such as late submission of claims largely by public hospitals and hasten reimbursements back to the facilities,” she added.
NHIF CEO Peter Kamunyo said the exercise is part of key reforms the national insurer is undertaking to ensure the attainment of universal health coverage.
This, he said, is by making it easy to interact with members, be able to pay the hospitals in good time and to ensure that fraud cases are eliminated.