Mataracy
VIP Contributor
An employer registers itself and employees with the scheme. Thereafter, the employer affiliates itself with NHIS approved Health Maintenance Organisation(s), who now provides (s) the employees with a list of NHIS approved health care provider (public and private).
The employee registers himself or herself and dependants with such provider of his/her choice. Upon registration, a contributor presents his identity card to his chosen Primary health care provider for treatment. The contributor will be able to access care after a waiting period of thirty-five (35) days.
This will enable the completion of all administrative processes.
A contributor had the right yo change his Primary Health Care Provider after a minimum period of six (6) months if he is not satisfied with his services.
Payment for services rendered yo him will be made to the Health Care Provider by the Health Maintenance Organisation (HMO).
A contributor may, however, be asked to make a small co-payment, where applicable, at the point of services.
PAYMENT METHOD(SYSTEM)
Health Care Providers under this programme will either be paid by capitation or fee-for-service.
(a) Capitation:- This is the payment to a Primary Health Care Provider by HMOs on behalf of a contributor, for services rendered by the provider.
This payment is made regularly in advance for services to be rendered.
(b) Fee-for-Service:- This payment is made by HMO to non-capitation receiving Health Care Providers who render services on referral from other approved providers.
The employee registers himself or herself and dependants with such provider of his/her choice. Upon registration, a contributor presents his identity card to his chosen Primary health care provider for treatment. The contributor will be able to access care after a waiting period of thirty-five (35) days.
This will enable the completion of all administrative processes.
A contributor had the right yo change his Primary Health Care Provider after a minimum period of six (6) months if he is not satisfied with his services.
Payment for services rendered yo him will be made to the Health Care Provider by the Health Maintenance Organisation (HMO).
A contributor may, however, be asked to make a small co-payment, where applicable, at the point of services.
PAYMENT METHOD(SYSTEM)
Health Care Providers under this programme will either be paid by capitation or fee-for-service.
(a) Capitation:- This is the payment to a Primary Health Care Provider by HMOs on behalf of a contributor, for services rendered by the provider.
This payment is made regularly in advance for services to be rendered.
(b) Fee-for-Service:- This payment is made by HMO to non-capitation receiving Health Care Providers who render services on referral from other approved providers.