NAN Archive

Loading

NAN Archive

Tag HMO

Health

HMO demands feedback from enrollees on service delivery

HMO demands feedback from enrollees on service delivery
By Talatu Maiwada
Feedback
Abuja, Aug. 16, 2018 (NAN) Managed Healthcare Services, a Health Management Organisation (HMO), has called for feedback from enrolees of National Health Insurance Scheme (NHIS) on service delivery at the country’s healthcare facilities.
Mr Roberts Ukeje, the Abuja Branch Manager of the organisation, made the appeal during an awareness programme on rights of enrollees at the News Agency of Nigeria (NAN) in Abuja.
He said regular feedback by enrollees would enhance visibility to areas of improvement as well as the enforcement of quality standard in hospitals across the country.
Ukeje however noted that the organisation was ensuring that the scheme works for all Nigerians and enrollees enjoy quality healthcare services in the hospitals.
He said feedback from enrollee experiences at service delivery points would assist the scheme to sustain and improve quality care.
He explained that the organisation had deployed members of staff to some hospitals where regular complains are received to ensure compliance with the required standards.
According to him, the posted workers have the mandate to ensure that enrollees were well treated and rights are not trampled upon.
On the rights of enrollees, Ukeje said every enrollee registered under the scheme has a right to access medical treatment as outlined in the NHIS benefit package.
“Enrollees also have a right to select a healthcare facility of their choice as long as the facility is accredited by the scheme.
“Right to change a primary healthcare facility after six months of access if not satisfied with the services provided.
“Right to change facility once it has closed, relocated or been delisted by the NHIS and right to change if you have been transferred to another location.
“Right to choose an alternative facility for dependents if they are living in a different location,’’ he said.
Ukeje listed others as the rights to access healthcare at any NHIS accredited facility in an emergency.
Right to complain to NHIS or Health Maintenance Organisations about any act of negligence on the part of the healthcare facility and right to be referred for secondary and tertiary healthcare. (NAN)
TIM/MST
Edited by Muhammad Suleiman Tola

Health

NHIS: HMO sensitise enrollees on rights

NHIS: HMO sensitise enrollees on rights
By Talatu Maiwada
Rights
Abuja, Aug.16, 2018 (NAN) Managed Healthcare Services, a Health Management Organisation (HMO), has urged enrollees of the News Agency of Nigeria (NAN) to uphold their rights in order to enjoy prompt and top quality healthcare under the National Health Insurance Scheme (NHIS).
Mr Roberts Ukeje, the Abuja Branch Manager of the organisation, made the call during an awareness programme on the rights of NHIS enrollees, at NAN Headquarters in Abuja.
Ukeje said that the organisation was one of the HMO’s accredited by the NHIS to make patients a better health care consumer and to promote benefits of wellness.
He explained that the HMO, in accordance with its statutory mandate and in commitment to its social responsibility, recognises the enrollee as the central figure of the health insurance practice.
“The enrollees are supposed to know their rights and benefits package entitled to them, they are the kings and major stakeholders and we are committed to ensuring that they are fully abreast of their benefits.
“The scheme therefore is determined to ensure that the enrollees enjoy prompt and adequate healthcare at all times,” he said.
The manager said the services, also known as `benefit package’ are what enrollees stand to gain.
Ukeje however regretted that paucity of and controlled funds have hindered the scheme from covering all ailments.
He explained that the benefits package was categorised under the primary, secondary and tertiary health care levels.
According to him, the primary health care level includes out-patient care, drugs, maternity care for up to four live births, routine immunisation, child welfare services, family planning services, emergency care, obstetrics and gynaecology.
The manager said that the secondary and tertiary health care categories undertake all procedures that could not be handled at the primary and secondary levels with a referral letter due to need for specialised investigation.
Ukeje noted that the secondary and tertiary levels handle surgical procedures, consultation with specialists such as physicians, dental surgeons, paediatrician, psychiatrist, orthopaedic, radiologist, physiotherapist and dental health, among others.
According to him, exclusion packages which are services not covered by the NHIS comprised partial and total exclusion.
He said the partial exclusion involved high technology investigations during which the HMO pays 50 per cent while the enrollees pay 50 per cent of the medical bill.
“This includes dialysis for acute renal failure, CT scan and life threatening emergencies,’’ Ukeje said.
Total exclusion, he explained, were services excluded from the benefit package of the NHIS, including occupational and industrial injuries, injuries resulting from natural disasters, epidemics, treatment of congenital abnormalities and cosmetic surgeries.
The manager added that enrollees were supposed to pay only 10 per cent total cost of their prescribed drugs and not for the entire treatment, emphasising that other cost incurred has been covered by the capitation fee.
He therefore urged enrollees to be well informed about the packages and give feedback to the agency as well as their HMOs on any challenges encountered while receiving services in facilities under the scheme.
Ukeje said that the scheme could be contacted on various platforms and call centre lines, including NHIS E-mail: mailto:info@nhis.gov.ng”; info@nhis.gov.ng; Website: http://www.nhis.gov.ng”; and www.nhis.gov.ng.
He also gave the contacts for Managed Health Care call centre lines as: 08079992600; 08079992842; 09071348217; 08054706468, and 070010008000. (NAN)
TIM/MS/MST
Edited by Mustapha Sumaila/Muhammad Suleiman Tola

Health

HMO kicks against reinstatement of NHIS boss

HMO rejects against reinstatement of NHIS boss
NAN-HG-12
Reaction
Abuja, Feb. 7, 2018 (NAN) Mr Lekan Ewenla, Managing Director, Ultimate Managed Healthcare, has advised the Federal Government against the reinstatement of Prof. Usman Yusuf as NHIS Executive Secretary.
Ewenla told the News Agency of Nigeria (NAN) on phone in Abuja that on Wednesday that the development was “worrisome and disturbing’’.
The federal government on Tuesday directed for the immediate reinstatement of Yusuf as the substantive chief executive officer of the National Health Insurance Scheme (NHIS).
He was suspended from office by the Minister of Health, Prof. Isaac Adewole, in June last year, following allegations of gross misconduct.
Reacting, Ewenla said: “What happened yesterday (Feb. 6) is quite worrisome and disturbing.
“But for whatever action taken there must be a rationale for it.’’
According to him, Yusuf was found quilty of alleged corruption by an investigative panel.
He cautioned the federal government that the global community was monitoring the anti-corruption posture of Nigeria.
He noted that such action could be misconstrued as a promotion of nepotism and corruption.
Ewenla, who is also the Publicity Secretary of Health and Managed Care Association of Nigeria (HMCAN), said the group would make its position on the reinstatement formally known on Friday.

Meanwhile, Mr Ayo Osinlu, Head, Media and Public Relations of NHIS, told NAN on Wednesday in Abuja that Yusuf was yet to resume office.
Osinlu said: “NHIS Executive Secretary, Prof. Usman Yusuf is yet to resume office after his reinstatement by the Federal Government on Tuesday, Feb. 6.
“The Acting Executive Secretary, Malam Attahiru Ibrahim, and the Minister of Health, Prof. Issac Adewole, were invited to the Presidential Villa and we are waiting the outcome of the meeting.”
NAN also reports that there is normalcy in the premises of the agency while security agents were seen keeping vigil. (NAN)
TIM/MST
Edited by Muhammad Suleiman Tola