HMO OFFICE SETUP AND MANAGEMENT FOR HOSPITALS

The managed care industry in Nigeria has grown tremendously over the years. By multiplier effect, the industry is estimated to employ about 1% of the population and still is expanding.

As a result, there is improvement in healthcare delivery, learning, healthcare costing and payments, and enrollee satisfaction.

However, some hospitals are still grappling with a number of challenges including the following:
● Effective and efficient running of the HMO unit/department in their facilities – We help facilities to determine the most effective and efficient way to run an HMO unit by determining the office size, personnel requirement, training, budget and remuneration;

● Business development – We assist facilities to draft MOU/SLAs with HMOs, review existing contracts and tariffs and recommending action for the non-performing HMOs;

● Debt recovery – One major challenge that medical facilities now have to grapple with is the issue of ever-rising external debts. Our work is to assist medical facilities to recover the debts, propose ways and strategies of preventing re occurrence and recommend systems to keep track of transactions between them (medical facilities) and their clients/ client organizations;

● Information gap - We have also noticed a huge gap between what the HMOs require/expect from medical facilities and what the medical facilities do. This is partly responsible for the loss of revenue by medical facilities in terms of excessive vetting and payment denial (in extreme cases) by the HMOs. Our work, therefore, is to train HMO desk officers in hospitals on general and specific HMO standard requirements.

To engage our services on the above, CONTACT US HERE.

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