ELECTRONIC CLAIMS SYSTEM

NHIF card obsolete, hospitals get new instructions

Health facilities allowed to take fingerprints of members before they can offer any services

In Summary

•However, NHIF encouraged members to register before they need health services, through NHIF branch offices, satellites and huduma centres countrywide.

•All health facilities have already been enrolled on the Electronic- claims management system, which ensures that when an NHIF member visits a hospital, the records are uploaded online in real-time.

NHIF boss Peter Kamunyo
NHIF boss Peter Kamunyo
Image: FILE

NHIF members who have not enrolled on the new biometric system can still access services if they visit health facilities with their now obsolete cards.

The cards were phased out on July 11 and beneficiaries now use their fingerprints for identification.  

On Wednesday, the fund said it recognizes thousands of its members have still not enrolled on the biometric system.

“If members get sick before they are biometrically registered, the accredited hospitals will biometrically register them before seeking any services,” the fund said in a statement.

“NHIF has empowered and equipped accredited hospitals to ensure that before members seek services they can be registered biometrically. The process will continue until everyone is registered.”

However, NHIF encouraged members to register before they need health services, through branch offices, satellites and huduma centres countrywide.

The National Hospital Insurance Fund covers about 25 million Kenyans, of whom seven million are principal members.

“Members and their dependents can visit the nearest NHIF service points or contracted hospitals countrywide to be biometrically enrolled,” CEO Peter Kamunyo said.

In cases where the principal member is in a different location from the dependants, the dependants can visit the branches or nearest huduma centres to be registered biometrically.

Where the members have no fingerprint or have no limbs they can still access biometric services through a password.

Until last month, members used the national identity card and their NHIF card to get services.

This was linked to increased fraud and several people have been prosecuted for sharing cards.

The new system will also speed up approvals for patients and reimbursements for health facilities.

All health facilities have already been enrolled on the Electronic- claims management system, which ensures that when an NHIF member visits a hospital, the records are uploaded online in real-time.

“This will ensure that there will be rapid turnaround time and reduce fraud, wastage and abuse,” the fund said.

The E-claim connectivity will also tackle fictitious claims by health facilities because the member must have been present in the hospital and verified through their biometrics.

Claims from hospitals are now submitted in real-time; thus delayed submission of claims is being minimized.

Currently, NHIF is carrying out mass registration of the one million poor Kenyans whose premiums will be paid by the government.

So far, the fund has registered all indigents in Taita Taveta, Nyandarua, Laikipia, Nakuru and Nyeri.

The exercise is expected to end next month, paving way for the rollout of the Universal Health Coverage.

In the 2019-20 financial year, the fund collected Sh60.81 billion from its 8.998 million members at that time and paid out Sh54.3 billion in claims.

The biometric registration is not new, having begun in 2015 among civil servants and security officers before it stalled.

Private insurers have also adopted the use of biometric identification.

 

Edited by Kiilu Damaris

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