Tag: BBM

More Nigerians can now   access quality healthcare  under the National Health Insurance Scheme (NHIS), with a Health Management Organisation (HMO),   Avon Healthcare Limited, has introducing six plans for individuals, families/groups, as well as associations.

According to the Managing Director, Mrs Adesimbo Ukiri, the plans will accommodate some seemingly uncaptured sections of the society, thereby ensuring adequate coverage of the typical and prevalent ailments found in the country, while providing quality care at affordable costs.

Mrs. Ukiri said although achieving Universal Health coverage in Nigeria is not a sprint to be won overnight, ”the introduction of Avon HMO’s Health plans for Individuals and families is a crucial step in the right direction. The Core Plan is N15, 000 per annual. There are international plans developed for Nigerians who travel abroad frequently and want assurance of seamless healthcare coverage no matter where they are in the world. The plans will supplement the company’s existing suite of health plans for companies and businesses. These plans came up because NHIS has licensed and accredited AVON as a national HMO.”

She said: “Avon HMO is thus able to offer not only its own private health plans, but also the full array of NHIS plans to individuals, associations, communities and governments across all states and regions. Avon HMO is set in raising quality assurance standards in the health insurance industry.

“Our focus on quality assurance is painstaking and we work very closely with provider hospitals to ensure that our enrolled members receive the best care. For instance, Avon HMO Case Managers have scheduled daily visits to hospitals to engage with enrolled members on admission, overseeing the care they receive and providing further assurances; over 75 per cent of all recorded admissions are visited in this manner. The company’s coordinators are working with provider hospitals to achieve adherence to agreed disease management protocols and drug formularies to sustain high levels of clinical and pharmacy quality to Avon HMO’s enrolled members.

“We are pleased to state that 98 per cent of our hospitals adhere to the Drug Formulary, thus ensuring that effective drugs are given to our patients. In recognition of the crucial role Provider Hospitals play and their resultant well-deserved right to adequate and effective remuneration, Avon HMO ensures capitation payments to relevant provider hospitals are paid before the first day of the month and claims are processed and paid within a 30 to 45 days cycle of receipt,’ she stated.

She added: “The company has a robust complaints resolution procedure, as such utilising multiple channels of calls, text, email, BBM and chat through which complaints are received, resolved and confirmation of resolution obtained. The sector still has a number of challenges which may affect service delivery. However, at Avon HMO, our processes are streamlined and the resolution time for most issues fall within a five to 15 minutes window.”