The Effects of Delays in Reimbursement of Claims by National Health Insurance Authority on Financial Management of Health Care Facilities in Brong Ahafo Region of Ghana
health care system is of a major concern to countries all over the world. The Act
of Parliament (Act 650) passed in 2003 health care financing and being implemented
and supervised by the National Health Insurance Authority (NHIA). National Health
Insurance Authority aimed to assure equitable and universal access for all residents
of Ghana to an acceptable quality package of essential health care services without
payment being required at the point of use. The efficiency and sustainability of
the health care facilities depend on funding and timely disbursement of claims.
It has been observed that, whilst health care facilities do comply with section
37 (7) of L.1 1809, the scheme has not been able to comply with section 38(1) of
the L.1 1809. This leads to undue delays in reimbursement of funds to accredited
institutions. This delays of reimbursement of claims by National Health Insurance
Authority therefore has adverse effects on the financial management of health care
facilities. It is therefore recommended that, Government should speed up on releasing
funds to National Health Insurance Authority for payment of claims. Further research
needs to be done to verify the findings among other groups of facilities, and explore
comparative studies involving facilities from different industries. Future researchers
should also develop measures of additional dimensions to find out if the premium
charged on scheme members of NHIS is fair enough to pay claims and also suggest
whether premium charged should be increased or maintained.
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