The National Health Insurance Scheme (NHIS) says it has made an early and immediate release of funds for the payment of capitation and fee-for-service for its enrollees for the second quarter (April to June) of 2020, in response to the Coronavirus pandemic in the country.
NHIS said was to guarantee uninterrupted access to healthcare services by enrolees of the Scheme and ensure that no enrolee will be turned back from any facility for non-payment of appropriate fees by any Health Maintenance Organizations (HMOs).
Ayo Osinlu, Head of Media & Public Relations in a statement on Tuesday, said the scheme took the step to ensure that the looming threat of COVID-19 is not compounded for the enrolees by their inability to access healthcare services at the points of need.
Responding further to the situation, NHIS has issued guidelines to the HealthCare Facilities (HCFs) and the HMOs on certain actions to be taken towards protecting the interests of the enrollees in the current situation, Osinlu stated.
He explained that the guidelines contain concrete provisions to prevent service failure, and also ensure that enrolees enjoy prompt and effective healthcare services in spite of general restrictions and outright lockdown in certain parts of the country.
“The guidelines gave clear order to healthcare providers to ensure the safety and protection of their personnel against COVID-19 infection, provide timely and appropriate level of care for all NHIS enrolees as may be required, and ensure that no NHIS enrollees is denied access to care,” it said.
NHIS explained that the guidelines also directed the providers to note that all its and HMO Call Centres are open 24 hours daily.
“They are also to ensure the issuance of authorization codes and resolution of all other issues, ensure prompt report of all cases of denial of authorization codes by HMOs, as well as maintain high index of suspicion and promptly report suspected cases to NCDC or State Ministries of Health,” Osinlu said.
Osinlu added that the guidelines for the HMOs instructed them to also ensure the safety and protection of their personnel against COVID-19 infection, ensure prompt payment of capitation and fee-for-service to all healthcare facilities, while also ensuring the provision of timely and appropriate level of care for all NHIS enrolees by the healthcare facilities.
He also said the HMOs are, by the guidelines, required to ensure that no NHIS enrolee is denied access to care, while their call centres are to be open 24 hours daily, for prompt issuance of authorization codes and to resolve all other issues that may arise.
“They are equally directed to log all cases of issued or denied requests for authorization code by healthcare facilities,” he said.
The Scheme advised all its stakeholders to adhere strictly to Local, State and Federal Public Health recommendations to curb the spread of COVID-19 in the country.