Dr Patrick Korie, the Chief Executive of SUNU Health Nigeria, says doctors should test patients for malaria before and after giving them treatment to ensure better healthcare delivery and reduced treatment costs.
Korie, who said malaria took about 70 per cent of health insurance payments, gave the advice during the SUNU Health Provider / Enrolee Forum in Umuahia on Friday.
He said that treating patients for malaria based on complaints and symptoms without first testing them raised the risk of patients being treated wrongly which also exposed them to the risk of developing drug resistance.
Korie said the health insurance company was working in collaboration with CODIX Pharma Limited to provide malaria tests kits to ensure quick tests on patients.
He said that the company, Managed Health, had changed its name to SUNU Health to ensure it aligned with its international parent company (SUNU Group) and to make their services accessible online.
Korie said SUNU is Wolof word meaning “Our Own” and which is the name their parent company bears.
He said the company was developing internet-based applications that would assist the National Health Insurance Scheme (NHIS) enrollees on its platform to access better and timely services.
Korie advised enrollees to apply for refund if the hospital or service provider they were using prescribed a drug that was unavailable at their pharmacy warranting purchase of such drug outside.
He, however, said that such claims could only be honoured if it could be backed by receipts and other facts.
The Abia State Coordinator of NHIS, Mr Camillus Eke, said hospitals certified only for primary healthcare could move to secondary care if they upgraded their personnel.
He said it was impossible for a medical doctor that is a general practitioner to expect to be allowed to perform surgery, adding that such doctors must upgrade their hospitals and personnel to take up secondary services.
Eke urged Health Management Organizations (HMOs) to always pay service providers who have offered their services through the scheme without delay stressing that the patients had paid for the services rendered already.
Dr Ifeoma Chikezie, SUNU Regional Head, Network and Claims, said service providers should justify their claims to ensure prompt payment for services.
She urged them to be specific and clear with laboratory tests done, ailments treated and drugs given to patients as well as clarify patients’ status and age to avoid confusion.
Chikezie said that a situation where a “hospital claims to have received malaria fever complaint, then it conducts lipid test and prescribes drugs meant to treat upper respiratory tract infection” was unacceptable.(NAN)