Abstract:
The processing of claims is very cumbersome and at a cost to the service providers, therefore the need to design software to eliminate the deficiencies in the existing system. The centralized NHIS claims systems will reduce the extra cost of acquiring health management system and thereby encourage more providers to associate with the insurance scheme. It will as well facilitate the ease and prompt payment of provider’s claims. NHIS claims systems streamline claims processing, speed access to customer information, and ensure the security of private medical information. This also reduce the labour costs associated with processing covered lives claims, thereby utilizing a single platform for all incoming data sources, automatically route claims for review and approval, and increase the accuracy and timeliness of payments. Shrink your paper storage and document retrieval costs while complying with regulatory standards. Though this project would be applicable to every hospital or health institution that serves as a NHIS service provider, it mainly factors Nyame Ani Hospital health insurance system as the area of research or case study. Since its inception, the Nyame Ani Hospital has been one of the reliable providers especially to its customers. (NHIS Directorate, 2011).
