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National Health Insurance Scheme

Credentialing


The National Health Insurance Authority (NHIA) engages healthcare providers to offer services to insured members through a process called credentialing. The credentialing process is to ensure that healthcare providers are in a position to provide basic quality health services to insured members in Ghana in accordance with the Benefit Packages within the National Health Insurance Scheme and/or Private Health Insurance Scheme. Credentialing promotes quality improvement in health care delivery, nurtures a healthy competition among service providers as well as grows public confidence in the health system For a healthcare provider to be credentialed with NHIA, the provider must complete an application, with the requisite documentation.
Documents required must have the following;

  • Current primary regulators certificate and copy of retention indicating healthcare provider is in good standing. Example: HeFRA, Pharmacy Council certificate
  • Current certificate from Register- General (where applicable) and proof of renewal for Private Providers.
  • Current Association membership certificate and proof of renewal of membership. Example: CHAG
  • Must pay required fees for requested level of credentialing.
  • Photo copies of certificates of professionals practicing at the facility and proof of retention with their appropriate regulatory bodies.

The National Health Insurance Authority (NHIA) wishes to bring to the attention of the general public and healthcare providers that it has completed processes to receive and process applications for credentialing of healthcare providers on an online platform, which will ease provider experience with the credentialing process Healthcare providers who wish to acquire new credential or renew their existing credential are to follow the steps below:

  • 1. Providers are to send an email to the address credentialing@nhia.gov.gh
  • 2. The email as stated above should indicate the following;
    • a. Name of facility
    • b. Name of an officer from the facility that will manage the facility’s account on the online platform
    • c. An official email address of the facility that will be used to create a user account for the facility
    • d. The type of credentialing the facility seeks to acquire i.e., NHIS or PHIS credentialing or both
    • e. The telephone number of the facility
    • f. A copy of the HeFRA/CHAG certificate of the facility attached as a pdf (where applicable)
    • g. A copy of the business registration documents of the facility attached as a pdf (where applicable)

Please note that an invoice will be generated upon completion of the application online with the instructions to complete payment.



CREDENTIALING APPLICATION PROCESSING FEES FOR THE VARIOUS FACILITY LEVELS

TYPE OF FACILITYAMOUNT (GH¢)
CHPS COMPOUND200.00
CHPS COMPOUND WITH MIDWIFE600.00
CHEMICAL SHOP 600.00
PHARMACY 1,050.00
LABORATORY, ULTRASOUND (STAND ALONE) 1,050.00
MATERNITY HOME, HEALTH CENTRE 1,200.00
CLINIC 2,000.00
DIAGNOSTIC SERVICES ( X-RAY,+ LABORATORY, + ULTRASOUND) 2,000.00
PRIMARY HOSPITAL, POLYCLINIC 3,000.00
SECONDARY HOSPITAL5,000.00
TERTIARY HOSPITAL10,000.00
  

Which Health care facility will go through credentialing?

Health Care facility of any ownership (public, private, mission, quasi-public) or type that is willing to operate with a Health Insurance scheme in Ghana can apply for credentialing.

Who is eligible to complete an Application Form?
What are the stages/processes involved in acquiring NHIA Credential?
How can I apply for Credentialing for a Health Care Facility?
How long does the Credentialing period last?
What will account for the denial of Credentialing of a Health Care Facility?

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