There are several healthcare providers in Nigeria. A Health Maintenance Organization (HMO) is an individual or public incorporated firm that is registered with the National Health Insurance Scheme merely for the aim of handling the delivery of healthcare services through Health Care Facilities that was accredited by the Scheme.
In 2012, there were sixty – six (66) accredited Health care providers in Nigeria. According to the present release on the NHIS website in 2014.
List of healthcare providers in Nigeria
These are the list of healthcare providers in Nigeria below:
- Hygeia HMO Limited
- Total Health Trust Limited
- Clearline International Limited
- Healthcare International Limited
- Medi Plan healthcare Limited
- Multishield Nigeria Limited
- United Healthcare International Limited
- Premium Health Limited
- International Health Services Limited
- Zenith Medicare Limited
- Zuma Health Trust
- Prepaid Medicare Services Limited
- Accessible Managed Care Limited
- MetroHealth HMO Limited
- Police Health Maintenance Limited
- Princeton Health Group
- Defence Health Maintenance Limited
- Healthcare Security Limited
- Strategic Health Planners Company Limited
- Sterling Health Care Managed Services Limited
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There are seventy-seven (77) health care providers in Nigeria that are currently operating. The rest of the other Healthcare providers in Nigeria can be accessed on the NHIS website
What are the functions of the healthcare providers in Nigeria?
Healthcare providers in Nigeria have many functions which include:
- Contribution collections from voluntary contributors
- Collection of contributions from employers that are registered and registered employees under the private health insurance.
- Ensure that the processing of claims (Secondary services) are carried out effectively
- Rendering to the Scheme monthly returns on capitation and fee-for-service payment within 30 days of the following month.
- Collection and submission of encounter data forms from Health Care Facilities (HCFs) to NHIS
- Contracting with only Health Care Facilities accredited by the Scheme for the purpose of rendering health care services
- Ensuring that contributions are kept in the Scheme’s accredited banks
- Establishing and ensuring a quality assurance system for the provision of quality healthcare by Health Care Facilities. Quality Assurance monitoring of HCFs by HMOs shall be quarterly and the reports sent to NHIS within one month.
- Ensure timely approval of referrals and undertake necessary follow up to complete referrals
- Carry out continuous sensitization of enrollees
- Marketing in accordance with NHIS Guidelines
- Marketing of health plans to employers/enrollees of different public and private sectors.
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