Experts have called on government to establish an Information Management System (IMS), alongside the National Health Insurance Scheme (NHIS).
These say the IMS, will save government from service providers who connive with patients to fraud government or Insurance company.
According to Dr. Edward Kanyesigye, the Board Chairperson of Mulago Hospital, government has to automate the system and kick out papers.
“I wonder no one has thought about this system yet it is vital because these issues of paper work will promote corruption, We know of hospitals which connive with patients to Bill higher so that they can get money from the provider, even if they are not sick,” he said.
The Health Ministry is in advanced plans of presenting the NHIS Bill 2022 so that it is if passed into law to enable all Ugandans who cant access medical care due to funds constraints do so.
He made these remarks while officiating the launch of the Smart EDI product of Smart Applications International (U) Ltd at Sheraton Hotel on Tuesday this week.
The Smart EDI platform, he said will foster better service delivery and enhance relationships between key stakeholders within the medical healthcare industry.
‘He asked the Insurance industry to embrace technology and innovation but also adopt EDI as a best standard practice in eliminating service provision challenges.
The Smart EDI was launched, under the theme: Automation of healthcare processes through Electronic Data Interchange (EDI)”
Dr. Kanyesigye said that this is well aligned to the future of healthcare in Uganda, since the industry is ailing with manual processes that are bulky and promotes unnecessary delays in processing of claims and ultimately delayed payments by the payers/insurance companies.
EDI is an interconnecting online platform that has been created to revamp claims delivery processes within the medical insurance sector and is aimed at achieving completeness in Electronic Claims Delivery, reduced Claims Rejections, enhancing Claim Processing Status Visibility, enhanced reconciliation process with online remittance reports, enhancement and support for paperless processes, among others.
“Smart believes that the launch of EDI will be a game changer in the medical industry. It will not only improve the claims submission process, but it will create a better working relationship between the medical insurance providers and medical health facilities.” Judy Mugoya, Country Manager, Smart Applications Int (U) Ltd said during the launch.
She said that the medical field is a dynamic space and there have been tremendous growth in the adoption of technology in the delivery of health services, especially during the Covid 19 pandemic.
Partison Ndyamuhaki, Head of Medical, Sanlam Life Insurance Ltd said that the future of healthcare lies in technological innovations in delivering accessible, affordable, and quality health care.
“In the bid to fully automate healthcare claims as part of our 2023 technology plan, we found it best fit to adopt the smart EDI (Electronic Data Interchange) platform for the value proposition it presents to Sanlam,” he said.
