Mon, December 06, 2021

in-focus

NHSO speeds up payments as healthcare sector struggles with rising Covid cases


The Covid-19 outbreak continues to strain healthcare providers physically and financially as they have to cope with the increased workload of screening patients and treating the infected. Extra work always comes with extra costs.

Even though these costs will eventually be repaid, the reimbursement process may not be fast enough for many healthcare facilities to keep up with the rapid increase in operating costs.

The National Health Security Office (NHSO) is well aware of this problem and is trying to adjust its financial reimbursement system to better cope with the changing situation of Covid-19 and the financial impact on these healthcare providers.

The NHSO’s ultimate goal is to make it possible to pay all financial reimbursement to service providers instantly after claims are submitted, said NHSO secretary-general Dr Jadej Thammatach-aree.

To achieve that goal, the NHSO continues improving its information technology system, a task that needs more time to achieve as it deals with a substantial database system, he said.

Previously, the NHSO allowed healthcare providers under the Universal Coverage Scheme to submit claims for reimbursement once a month. This has now changed to every 15 days, Dr Jadej said.

“We hope this change will help improve hospitals’ liquidity and their ability to cope better with the changing outbreak situation that requires both work efficiency and flexibility,” he said.

Artificial intelligence (AI) has also been adopted to make the compensation process more efficient, he said.

From the beginning of this year until the end of March, a total of 781,625 Covid-19 tests have been carried out, which cost the NHSO THB1.86 billion and THB1.49 billion was spent on treating 31,488 Covid-19 patents at the same time.

Screening is a crucial mechanism for containing the outbreak. The National Health Security Fund had initially started offering Covid-19 screening and laboratory testing to people who meet the patient under investigation (PUI) criteria set by the Department of Disease Control for deciding as to who should be given a free Covid-19 test.

Most recently, the NHSO has announced that physicians will decide on a case-to-case basis as to who else should be screened for Covid-19 and the cost of testing will be covered by the NHSO.

Along with this change in the Covid-19 screening policy, the NHSO has also encouraged private hospitals that aren’t contracted under the Universal Coverage Scheme to become part of the same Covid-19 screening network.

The NHSO covers four types of Covid-19 tests, namely reverse transcription-polymerase chain reaction (RT-PCR) tests via nasal and throat swaps, RT-PCR testing of pooled saliva samples combined with pooled nasal and throat swab samples, antibody testing and antigen testing.

The NHSO has already reached an agreement with private hospitals that they must not charge any new confirmed Covid-19 patient who needs to be admitted for treatment, Dr Jadej said.

Reimbursement for such providers will be made under the Universal Coverage for Emergency Patients (UCEP) unless the service is already covered by the patients’ own health insurance policies.

“Since Covid-19 is considered a health emergency that comes as a heavy financial burden to many people, we would like to assure all of you that if you strictly follow advice by doctors at the healthcare facility you are receiving [Covid-19 treatment] services, you won’t have to pay any extra costs,” he said.

In a bid to help everyone find Covid-19 screening test at a healthcare facility closest to his or her home, the NHSO has on its website provided information detailing what people are entitled to and which healthcare facilities they should consider visiting.

The National Health Security Board has also approved a proposal about regulations governing the spending of THB3.75 billion baht received from the government.

The fund was allocated to the NHSO under a Cabinet resolution reached on March 30.

Of the THB3.75 billion, THB3.65 billion will go to healthcare services associated with Covid-19 and the remainder will be spent on other related costs.

The Cabinet wants this amount to be spent separately from the UCS payment.

This is how the NHSO has been working to boost public confidence in access to healthcare services necessary for saving lives and curbing the spread of Covid-19 since it emerged early last year.

Published : May 07, 2021

By : The Nation