‘Health institutions taking double benefit under healthcare program’

Health Insurance

Kathmandu: Health institutions are taking advantage of the state’s poor information and claim tracking system. It has been found that many health institutions have received claims from the state’s different agencies for the same healthcare service to the same beneficiary.

According to the Health Insurance Board(HIB), health institutions have made claims to the Board even after reimbursement by the state under the ‘Healthcare and Medication Program for Ultra Poor Citizen’. The Board has publically requested associated health institutions to avoid making double claims for the same service delivery.

According to the Board, claims for the kidney dialysis services delivered to the ultra-poor people have been submitted both to Health Insurance Board and Healthcare and Medication Program for Ultra Poor Citizens. Such forgery in claims can be identified by the implementation integrated healthcare database system. But the state has not made such arrangements to curb the exploitation of state funds by a handful of health institutions.

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