The Rivers State Contributory Health Protection Programme (RIVCHPP) has reiterated its commitment to strengthening an efficient, transparent and accountable claims management system to improve healthcare service delivery to enrollees across the state.
The Executive Secretary/Chief Executive Officer of RIVCHPP, Dr. Vetty Agala, gave the charge during a meeting with the Programme’s Claims Management Team.
Agala stressed the need for diligence, professionalism and strict adherence to established procedures in the processing, vetting and management of healthcare claims.
She urged members of the team to remain vigilant in the discharge of their responsibilities, particularly in identifying and preventing fraud, abuse, waste and other practices capable of undermining the sustainability of the health insurance scheme.
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The RIVCHPP boss noted that effective claims management was critical to ensuring that healthcare providers were appropriately reimbursed for legitimate services rendered while safeguarding the Programme’s resources from fraudulent or unnecessary claims.
According to her, every claim must undergo proper scrutiny, verification and documentation to ensure that only genuine and medically necessary services are approved for payment.
Agala further charged the team to uphold transparency, accountability and efficiency, while encouraging members to embrace teamwork, continuous learning and the effective use of available systems and processes to enhance claims assessment and payment.
She disclosed that the agency had procured tablets to support claims management and improve efficiency in the process.
Agala reaffirmed RIVCHPP’s commitment to strengthening its internal controls and claims management mechanisms as part of broader efforts to prevent financial leakages and ensure sustainable access to quality healthcare for residents of Rivers State.
She said the initiative was in line with the administration of Governor Siminalayi Fubara’s efforts to improve healthcare delivery across the state.
