NHIF rolls out biometric kits to end medical fraud, project to be completed in 3 years

The NHIF has embarked on the use of fingerprints to identify all its members when seeking services in health facilities. CEO Geoffrey ...


The NHIF has embarked on the use of fingerprints to identify all its members when seeking services in health facilities.
CEO Geoffrey Mwangi said the fund has completed the biometric registration of civil servants and is in the process of enrolling other members.
The use of biometric identification is expected to reduce fraud.
“We have completed the process for civil servants. At least 1,370 hospitals have been fitted with biometric kits. In future, if we are enrolling a facility, it will have to fit these kits,” Mwangi told the Star.
He said the programme will take three years and will be completed by 2020. Mwangi said it will remain the standard for new members.
Currently, the fund has about 6.7 million principal members and in total, serves about 20 million Kenyans.
“We will device a multi-strategy and by June next year, we hope to do 60 per cent of members. We will most likely move from one organisation to another taking biometric details,” Mwangi said.
Biometrics is an automated method of identifying a person based mostly on physiological characteristics.
When a client scans a fingerprint, for instance, the system determines whether the pattern of ridges and valleys in the image match the pattern in pre-scanned image.
Last month, the NHIF also set up a pre-authorisation centre which approves all expenses for surgical conditions and services like MRI, CT scans, radiation and chemotherapy.
“Medical fraud is real in this sector. We recently took one facility in Ukambani to court. They did one surgical case and billed us for eight. We have 26 other facilities we are still investigating. If they border on fraud, we will submit them for criminal investigation,” Mwangi said.
The NHIF’s biometric solutions are offered by Dutch IT firm Genkey.
Medical fraud is a major problem across the world.
Often, it involves medics billing for services not offered, duplicating claims, offering excessive or unnecessary services.
Unnecessary service occurs when claims are filed for care that in no way applies to the condition of a patient, such as an echo-cardiogram billed for a patient with a sprained foot.
In 2015, the Kenyan insurance sector lost Sh324.7 million through fraudulent claims. According the Insurance Fraud Investigation Unit, this represented a 215 percent rise from Sh102.7million in the same period in 2014. Health insurance ranked third as the insurance class with the highest volume of fraud, followed by theft by insurance employees.

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Today in Kenya: NHIF rolls out biometric kits to end medical fraud, project to be completed in 3 years
NHIF rolls out biometric kits to end medical fraud, project to be completed in 3 years
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