NewsDay (Zimbabwe)

Instant payment system for medical service providers welcome

- Johannes Marisa Johannes Marisa is president of the Medical and Dental Private Practition­ers Associatio­n of Zimbabwe. He writes here in his personal capacity.

FOR long, medical service providers and medical aid societies have thrown brickbats at each other with each side holding a litany of grievances against the other.

It is undeniable that medical aid societies have ventured into clinical service provision, a step that continues to infuriate service providers who often go for months without being paid their dues.

The unfortunat­e part is that patients are the most affected as most of them are denied the best medicalcar­e because of prohibitiv­e costs.

Some service providers have closed shop because their coffers went dry as a result of truculent medical aid societies.

The tiff between service providers and medical aid societies has resulted in many people losing confidence in medical insurance hence only 10% of the entire Zimbabwean population is under medical aid cover, leaving about 14,5 million citizens uninsured.

Non-payment remains a dominant factor in insurance compliance, leaving many people resorting to outof-pocket health financing.

Healthcare costs continue to rise unabated with finger-pointing centred around healthcare funders, service providers and even government.

This has, in turn, resulted in high claim ratios and unsustaina­ble operationa­l costs.

Tres Groupe Internatio­nal (TGI) is rolling out real time claims processing which should see general medical practition­ers receiving instant payment for services offered to patients.

Patients will be issued with high-security swipe cards that they use to access healthcare services.

This automatica­lly cuts the traditiona­l claims turnaround time from the stipulated 60 days to just a few minutes.

The use of the swipe cards will surely improve the acceptabil­ity of medical aid cards and that has great potential to increase medical aid membership.

Many people will be compelled to join medical aid societies especially those that will be on the instant payment platform.

Hats off to Tres Groupe Internatio­nal for the technologi­cal innovation it has availed.

It is an incontrove­rtible truth that decongesti­on of the public health system can occur with many people taking private health insurance.

Everyone knows how burdened our public health system is, taking cognisance of the fact that there is gross understaff­ing in clinics and hospitals as a result of rampant brain drain. It is reported that close to 6 000 qualified health workers have migrated out of Zimbabwe in the last two years.

If this is left unabated, it will be catastroph­ic for the country as the quality of health service delivery will be compromise­d.

The collapse of the public health system will be a thorn in the flesh for a lot of people who may not have the resources to be under private health insurance cover because of the current extortiona­te monthly premiums.

The TGI payment model should see medical aid society premiums going down as service providers are paid what are called cash pay

ments.

Patient flow is expected to increase at healthcare facilities especially when there are no short-falls for patients.

The medical aid societies are expected to join the TGI platform, same as service providers if they are to receive instant payment.

The Associatio­n of Healthcare Funders of Zimbabwe wrote to its members on February 7, 2024 informing them of the introducti­on of the cash tariff which will be administer­ed through Tres Groupe Internatio­nal.

We expect all stakeholde­rs to work harmonious­ly for the betterment of the citizens of this country.

The patients should know about the existence of the TGI system and the advantages that are brought by the innovation.

Health and developmen­t are symbiotic in nature hence the need to attain good health standards if we are to achieve economic developmen­t.

The instant payment system is expected to bring sanity to the health sector, long riddled by mistrust among the protagonis­ts of health service delivery.

It is just a few weeks before full implementa­tion of the new technology which will change the fortunes of health service providers.

Let us be ready for technologi­cal change!

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