Uchenna Ezenwaka and Simeon Onyemaechi*
Objective: As healthcare becomes increasingly important to the economic and social development of any nation, the problems healthcare providers face in terms of efficiency and speed of service delivery need to be addressed. By deploying an electronic claims management system, these issues can be resolved, leading to improved efficiency in healthcare. This study examines the effects of deploying an electronic claims management system on the implementation of a sub-national health insurance scheme in Anambra State (ASHIS), Nigeria.
Methods: A qualitative study was conducted in Anambra state, Nigeria. Data were collected from stakeholders- health insurance managers and ASHIS-accredited healthcare providers- who play critical roles in claims management. Twenty in-depth interviews were conducted with the stakeholders to explore their experience and effectiveness of electronic claims management system. Data were analysed using a thematic approach.
Results: Manual claims management was stated to be cumbersome, time-consuming and error prone. The analysis revealed that implementation of the electronic claims management system increased the efficiency of the ASHIS in terms of speed, accuracy, transparency, convenience and cost savings. Furthermore, the system also resulted in greater customer satisfaction among the health service users. However, few respondents claimed that poor internet connectivity often challenges the process.
Conclusion: The study highlights the importance of deploying electronic claims management systems in providing efficient healthcare services, hence, the need to ensure its sustainability.
Published Date: 2023-09-19; Received Date: 2023-07-22
