Hospitals that turn away patients risk being delisted from the National Health Insurance Fund empanelment list.
This is after reports emerged on some facilities in the country turning away patients seeking services without clear explanation.
NHIF now calls on any affected member to report such incidents for proper investigation and action to be taken against such facilities where possible.
NHIF Nairobi Regional Manager Mary Nyachae on Monday said the fund has been dealing with such cases from across the country noting that such hospitals are doing so in contravention of their contracts with the insurer.
She noted that, on rare occasions, it happens when the patient’s cover is in arrears or the hospital they visited does not offer the services being sought.
“They should not be turned away instead they should be referred to where the service is offered; it becomes a complication when it is outpatient because you know members chose a particular hospital where they go,” Nyachae said.
“Sometimes they may be turned away without being given proper advice or reasons why they are being turned away, this is something that we keep encouraging our members to be able to ask why.”
NHIF has in the recent past tightened its noose on facilities contravening their contracts and dropped some for fraud and poor standards.
Some have been delisted for seeking reimbursement for services they did not offer.
