NHIF adapts Automated Fingerprint Verification to Curb Fraud
The National Hospital Insurance Fund (NHIF) is introducing the use of fingerprints to identify its 8.9 million members and their dependents to tackle fraud and speed up payment of medical claims.
Otieno Cynthia 
The State-funded medical insurance scheme has started an extensive biometric registration as it migrates from the use of the National Hospital Insurance Fund card and national identity card as the mode of identification. This comes to cub the provided loopholes for fraudulent claims.
This follows the previous hit by fraudulent claims of people using fake identities to seek medical care and hospitals processing false claims.
The biometric registration will run together with the installation of an electronic claims system as the National Hospital Insurance Fund moves to eliminate manual processing of hospital bills. Hospitals have up to July 11 to switch to an e-claim processing system and the National Hospital Insurance Fund members will need to be registered under biometrics to access their cover.
The National Hospital Insurance Fund Chief Executive Officer, Peter Kamunyo, reported to the Business Daily that the fingers of members and their dependents will be registered either at NHIF service points or contracted hospitals countrywide.
“We want to ensure all NHIF members are biometrically registered. This will improve efficiency in terms of access to healthcare since they will not have to carry their cards. It will also reduce fraud that rides on impersonation,” said Mr. Kamunyo.
The switch to biometrics identification will also eliminate the current challenge where NHIF issues one card for the contributor and their dependants, making it difficult for the beneficiaries to access service when the card is far from them.
E-claim system has already been deployed to hospitals in Western, Nyanza, Central, Coast, parts of Nairobi, Eastern and, Rift Valley regions. NHIF targets to cover the remaining regions by July 11.
“All healthcare providers will be submitting their claims electronically after July 11. This is will reduce the turnaround time for payments and cut issues of reconciliation,” said Mr. Kamunyo.
The e-claims system will also give NHIF real-time access to transaction records, patient visits, and the amounts charged.
NHIF is bracing for increased premium collections under the State’s universal healthcare plan that will make it compulsory for all adults to be members of the fund and for employers to top-up workers' contributions.
In the financial year ended June 2020, the NHIF collected Sh60.81 billion from the 8.998 million members and paid out Sh54.3 billion in claims.
NHIF currently uses biometric identification for civil servants and security agencies alone and therefore providing a window for non-contributors to use fake identities to seek medical care.
