NAIROBI, Kenya, Feb 6- More hospitals and health centers could be removed from the list of approved medical care providers by health insurance companies hot on the heels of the Nairobi Women’s Hospital saga.
Jubilee Holdings Chief Executive Officer Julius Kipng’etich says the firm has several hospitals on the watch list who are suspected of inflating hospital bills to steer profitability.
“More hospitals will be blacklisted because the aim of insurance firms is to reduce the cost of healthcare and we cannot go that route in our industry,” Kipng’etich told Capital business.
At the same time, Kipng’etich has urged insurance firms to be on the lookout of employees who collude with hospital staff to submit fictitious claims and bills to insurance companies to make money.
“I urge insurance companies to be vigilant and check on their individual workers because fraud cannot succeed without collusion between the two entities,” added Jubilee’s CEO Julius Kipng’etich.
This comes even as Kenya Association of Insurer’s chief executive Tom Gichuhi warned hospitals against attacking insurance companies who only want to pay for the correct bills.
“Hospital should not complain of being accused falsely. Insurers are only doing their work, which is to ensure patients get treated without worrying about money,” said Gichuhi.
Gichuhi also warned hospitals over inflating bills and urged them to adhere by the doctor’s codes of conduct.
Nairobi women’s hospital has been on the limelight since last week after leaked WhatsApp chats appeared to show how the hospital bosses set daily targets for the number of patients who should be admitted.
They show that the revenue, commissions, admissions, and discharge numbers were allegedly being actively monitored hourly, every day, and day and night by chief executive officer Felix Wanjala.
One of the patients who asked anonymity took a patient last week at the hospital’s branch where she was charged Sh50, 000 for dripping, only a few hours.
Others say, they were not aware of the situation until it was revealed through various media channels.
Whereas the Association of Kenya insurers issued a statement of the insurance companies suspending the facility, some have not.
“I came for a blood test and the first thing I was asked is if I have a medical card and I am covered under AON Insurance,” said one of the patients who also requested anonymity.
Nairobi Women’s issued a statement denying the allegations, saying it was conducting an internal review for assessment.