DOHA: The National Health Insurance Company (NHIC) is working on regulations to prevent patients from undergoing tests in more than one place and seeing many doctors for the same illness unless with a special request.
Once the regulations are in place, patients will have to give a special request explaining reasons to see a second doctor, a local Arabic daily reported yesterday quoting Dr Faleh Mohammed Hussein Ali, Acting CEO of NHIC.
He said the NHIC will soon deal with clinics and hospitals that don’t accept medical test reports issued by other facilities and would insist for repeat tests. “We will deal with this issue very soon, before the end of summer,” said Faleh Mohammed.
Seha currently covers all citizens and is planned to be expanded to expatriates by the end of next year.
He said some service providers — clinics and hospitals — have requested Seha to impose a punishment on patients who don’t stick to appointments, saying this is causing them financial losses. Seha has not proposed any punishments for this until now, he added.
However, an electronic system will be implemented soon through which a patient will be informed that he missed the appointment. In case of repeating this practice, the patient would be prevented from availing of the service.
He said a major problem facing Seha since its launch about two years ago is that people don’t properly understand the system.
“They think it is like a private health insurance system. This is a social insurance system,” said Faleh Mohamed Hussain.
In some countries patients need approval from the insurance provider before seeing a doctor. This is not the system in Qatar, he added.
He said NHIC will soon set up a committee with representatives from the private sector to lay down procedures related to cosmetic surgeries. Only cosmetic surgeries that are part of medical treatment are covered by Seha.
NHIC is preparing to launch the first phase of the national accreditation for health care providers, he said. Once the IT system is fully implemented it will enable the NHIC to see the actual bills and match them with the specifications. In case of unnecessary treatment, the service providers will not be paid for that.
He said NHIC is still in the process of assessing the total cost of Seha. That is why it is not announcing any figures.
A new IT system will be in place that will increase the efficiency of payment and avoid wastes. The providers will get what they deserve. “We are seeking establish a long term funding system to know the real cost of this system. We seek to pay fees to the hospitals according to the services they provide. If the private sector brings experts and conduct researches all that will be compensated and reflect on the quality of the service. This is just the beginning and the system will develop and improve in the coming stages,” said Faleh Mohammed.
The Peninsula
