Over 200,000 claims in one year – NHI WORRIED

With more than 200,000 claims being filed against the National Health Insurance (NHI) within its first year of operation, the Board of the state-owned entity and government minister Mark Vanterpool are concerned about how long the ‘flurry’ of claims will continue.

They recently told the Standing Finance Committee of the House of Assembly that they hope the relatively large number of claims is merely a result of the NHI programme being relatively new.

In a report tabled in the House of Assembly yesterday, the committee paraphrased Vanterpool and Director of the NHI Board Antoinette Skelton:

“[Vanterpool told the committee] the hope was that the claims would subside. The Director (Skelton) stated that she agreed with the honourable minister.”

“Ms Skelotn further stated that there were persons who had visited the doctor for the first time under the NHI who were very ill, and a few had stage four cancer. Hence, she believed that the [NHI] programme was doing what it was intended to do,” the Standing Finance Committee further reports.

Over 8,000 denied access

Meanwhile, Deputy Director at the NHI Roy Barry also appeared before the parliamentary committee, and confirmed a plethora of numbers in relation to the NHI’s first year of operation.

He said the exact number of claims filed last year was 207,214.

Of that number, 5 percent (8,364) of the claims was not approved.

According to the Standing Finance Committee, Barry explained why some claims for help were turned down.

“The Deputy Director (Barry) indicated that the reasons for denial could be that the payment contract did not cover the series of claims, the received date exceeded the billing time limit, or there was no valid referral for the claimant,” the committee reports.

Barry added that, of the total number of claims received by the NHI, 1,879 were still pending at the end of last year.

Gov’t still paying big bucks

Meanwhile, the Standing Finance Committee reported Barry as saying that Government was the largest contributor to the NHI during the first year of operation.

He disclosed that the total income for the NHI last year was $74,786,539.

Of that amount, the government directly contributed $41,326,300.

The remainder of the funds was collected from private contributors.

Up to the end of the year, there were 33,776 people registered with the NHI, Barry also disclosed.