The newly elected leadership of the Medical Superintendents’ Group of Ghana has paid a working visit to the headquarters of the National Health Insurance Authority (NHIA), raising concerns about challenges affecting claims management following the transition to the Ghana Health Information Management System (GHIMS) and the pending review of National Health Insurance Scheme (NHIS) tariffs.

The visit also served as an opportunity for the Group to formally introduce its newly elected executives to the Executive Management of the NHIA and discuss issues affecting healthcare providers under the NHIS.

Speaking during the meeting, the President of the Medical Superintendents’ Group, Dr. Eric Sarpong-Ntiamoah, commended the NHIA for the timely reimbursement of claims to healthcare providers, noting that the payments have helped health facilities sustain quality healthcare delivery across the country.

However, he highlighted difficulties encountered by some facilities following the migration from the Lightwave Health Information Management System (LHIMS) to GHIMS.

According to Dr. Sarpong-Ntiamoah, disruptions associated with the transition affected claims submissions by several healthcare facilities, preventing them from submitting claims for services rendered during certain periods and creating operational challenges.

He appealed to the Authority to explore interventions to support affected facilities and also sought updates on the long-awaited review of NHIS tariffs, citing rising healthcare delivery costs.

Responding to the concerns, the Chief Executive of the NHIA, Victor Asare Bampoe, acknowledged the challenges associated with the system migration and assured the Group that the Authority had been actively engaging stakeholders to identify appropriate solutions.

He explained that the NHIA had considered making payments based on average claims submitted by affected facilities and had obtained approval from its Governing Board to pursue the proposal.

However, consultations with the Ministry of Health and the Ministry of Finance revealed that existing Public Financial Management regulations do not permit payments without evidence of actual services rendered.

Dr. Bampoe stressed that while the Authority remains committed to supporting healthcare providers, it must operate within the legal and financial framework governing public expenditure.

He assured the medical superintendents that the NHIA would continue engaging the relevant authorities to find a practical and lawful solution to the challenges.

The Deputy Chief Executive for Operations, Dr. Kwesi Senanu Djokoto, also addressed concerns about NHIS tariffs, assuring the Group that the Authority was making steady progress toward a tariff review.

He disclosed that stakeholder consultations had been completed and that a draft proposal was currently undergoing the necessary approval processes.

According to Dr. Djokoto, the NHIA recognises the impact of rising operational costs on healthcare providers and is working to ensure that tariffs are adjusted to reflect prevailing economic conditions.

He further indicated that efforts are underway to improve the stability and functionality of the GHIMS platform to facilitate seamless claims submission and processing.

The Deputy Chief Executive for Finance and Investment, Madam Anatu Anne Seidu Bogobiri, reaffirmed that claims payments must be based on verifiable services rendered in accordance with existing financial regulations.

Management of the NHIA reiterated its commitment to strengthening collaboration with healthcare providers and addressing operational challenges affecting healthcare delivery under the NHIS.