To prevent delays for enrollees, the National Health Insurance Authority (NHIA) says it has implemented a strict one-hour authorisation approval limit.

Bethuel-Kasimu Abraham, the NHIA state coordinator for the Ikeja Office, disclosed this policy in Lagos on Thursday, on the sidelines of the SUNU Health Lagos-Ogun second-quarter providers forum.

Mr Abraham explained that hospital delays were frequently tied to prolonged authorisation protocols, a major pain point that has generated numerous complaints from patients.

According to him, because they’ve been having the complaints, they went back to re-strategise.

“We sat down, discussed with providers, with Health Maintenance Organisations (HMOs), and we came up with that one-hour authorisation approval limit.

”This is because there have been problems; there has been feedback that this is an area of concern.

”Don’t forget, time is one of the ways you measure quality in delivering healthcare. If you deliver healthcare when it’s belated, how high is that value?

”So that’s why we came up with that.

“For the issue of drugs, we are coming up with something that will take care of this thing finally,” he said.

Mr Abraham added that the NHIA would soon introduce sanctions for non-compliance, emphasising that enrollees must have access to their prescribed drugs and that out-of-stock medications at facility pharmacies were considered abnormal.

He appealed to enrollees who may have lost confidence in the healthcare system to remain hopeful and proactively share their experiences.

He tasked them with informing regulators and other key players about their challenges, noting that actionable feedback was essential for the NHIA to improve operations.

Merely complaining to bystanders, he warned, only served as feedback to the person listening at that moment.

If the grievance did not reach the proper authorities, it would not be acted upon.

Consequently, Mr Abraham encouraged enrollees to submit appropriate, formal feedback—including the facility’s name and the staff involved—via SMS, WhatsApp, or email.

Also speaking at the event, Dr Faith Nwachi, Chief Operating Officer (COO) of SUNU Health Nigeria Limited, described the forum as a vital interactive session that facilitates the flow of information among HMOs, healthcare providers, and the NHIA.

She noted that when the HMO receives feedback from providers, it analyses it collaboratively and relays accurate, timely information back to the facilities.

This exchange, she explained, clarified what the HMO must do to ensure that their mutual enrollees—the patients—received the benefits they were entitled to.

“Receive good, prompt access to care and quality care at the right place at the right time. They know what they are supposed to do to make that happen.

“The regulatory body also knows what they are supposed to do to make that happen.

“If any one of us is falling short in our responsibilities or roles, we will know it, and then we’ll go back and correct ourselves,” the COO said.

She reiterated that the entire system is centred on the enrollee.

She added that the ultimate goal was to ensure the patient received seamless service, with the HMO doing everything within the law to guarantee adequate healthcare.

(NAN)