The National Hospital Insurance Fund (NHIF) is introducing the use of fingerprints to identify its 8.9 million members and their dependants to tackle fraud and speed up payment of medical claims.
The State-funded medical insurance scheme has started mass biometric registration as it migrates from the use of NHIF card and national identity card as the mode of identification— both which have provided loopholes for fraudulent claims.
The scheme has previously been hit by fraudulent claims of people using fake identities to seek medical care and hospitals processing false claims.
The biometric registration will run together with the installation of electronic claims system as NHIF moves to eliminate manual processing of hospital bills. Hospitals have up to July 11 to switch to e-claim processing system and NHIF members will need to be registered under biometrics to access their cover.
NHIF CEO Peter Kamunyo told the Business Daily that the fingers of members and their dependents will be registered either at NHIF service points or contracted hospitals countrywide.
“We want to ensure all NHIF members are biometrically registered. This will improve on efficiency in terms of access to healthcare since they will not have to carry their cards. It will also reduce fraud that rides on impersonation,” said Mr Kamunyo.
The private sector adopted the use of biometric features years back and this has helped curb fraud that in 2009 caused revenue losses estimated at 40 per cent of total claims or Sh1.6 billion.
The switch to biometrics identification will also eliminate the current challenge where NHIF issues one card for the contributor and their dependants, making it difficult for the beneficiaries to access service when the card is far from them.
E-claim system has already been deployed to hospitals in Western, Nyanza, Central, Coast, parts of Nairobi, Eastern and, Rift Valley regions. NHIF targets to cover the remaining regions by July 11.
“All healthcare providers will be submitting their claims electronically after July 11. This is will reduce the turnaround time for payments and cut issues of reconciliation,” said Mr Kamunyo.
The e-claims system will also give NHIF real time access to transaction records, patient visits and the amounts charged.
NHIF is bracing for increased premium collections under the State’s universal healthcare plan that will make it compulsory for all adults to be members of the fund and for employers to top-up workers contributions.
In the financial year ended June 2020, the NHIF collected Sh60.81 billion from the 8.998 million members and paid out Sh54.3 billion in claims.
NHIF currently uses biometric identification for civil servants and security agencies alone and therefore providing window for non-contributors to use fake identities to seek medical care.