To prevent delays for enrollees, the National Health Insurance Authority (NHIA) has introduced a strict one-hour authorisation approval limit.
Mr. Bethuel-Kasimu Abraham, NHIA State Coordinator for the Ikeja Office, disclosed this policy in Lagos on Thursday during the SUNU Health Lagos-Ogun 2nd quarter providers forum.
Abraham explained that hospital delays were often caused by prolonged authorisation protocols, a major issue that has led to many patient complaints.
“Because of these complaints, we sat down with providers and Health Maintenance Organisations (HMOs) to restrategise,” he said.
“We came up with the one-hour authorisation approval limit. Time is one of the key ways to measure quality in healthcare. If care is delivered late, its value is diminished.”
Abraham added that the NHIA would soon introduce sanctions for non-compliance. He emphasised that enrollees must have access to their prescribed drugs, describing out-of-stock medications at facility pharmacies as unacceptable.
He appealed to enrollees who may have lost confidence in the system to remain hopeful and proactively share their experiences with the relevant authorities.
“Merely complaining to bystanders does not help. If your grievance does not reach the proper authorities, it will not be addressed,” he said.
Abraham encouraged enrollees to submit formal feedback, including the facility’s name and 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 platform for information exchange between HMOs, healthcare providers, and the NHIA.
“When the HMO receives feedback from providers, we analyse it collaboratively and relay accurate information back to the facilities,” she said.
“This exchange ensures that our mutual enrollees — the patients — receive the good, prompt, and quality care they are entitled to at the right place and time.
“The entire system centres on the enrollee. The ultimate goal is to guarantee seamless service and adequate healthcare for every patient.”
