The government will soon have a standardized billing for medical claims reimbursement rates across the health sector.
These are part of the reforms the new National Social Health Insurance Fund (NSHIF) aims to achieve.
The Ministry of Health in March initiated the process of restructuring the National Health Insurance Fund to a new NSHIF to increase the efficiency and transparency of the fund.
This means the new scheme once operationalised will pay a similar amount as claims for services rendered across all the healthcare facilities irrespective of whether they fall under public, private or faith-based.
“As we reform NHIF we want to have a new vehicle; a social health insurance that takes care of the needs of Kenyans, that should a patient choose to walk to Coptic hospital, Coptic will have its bill paid by a new social health insurance scheme,” Health CS Susan Nakhumicha said.
The CS spoke on Friday during the inauguration of the Heart Centre and Cath Lab Unit at Coptic Hospital.
Nakhumicha also said all claims will have to be verified before any payments are made.
During a meeting held in March, the leadership outlined the plans and strategies for restructuring NHIF to NSHIF, which will include expanding the number of services covered and the network of healthcare providers.
This seeks to ensure it benefits Kenyans in accessing quality and affordable healthcare and drive the attainment of the universal health coverage agenda.
Also discussed was the importance of public education and awareness-raising campaigns to ensure that Kenyans understand the benefits of the new NSHIF.
“The new one will work because one, we are developing an essential package, two we are costing so there will be a tariff and it will not matter where a patient gets care, whether they get it in public, private or faith-based it will be based on the tariff,” the CS said.
The CS noted that there currently exist several schemes that take care of different cohorts of people, adding that there is a need to consolidate them into one as one big fund.
