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Garden City University College: Department of I.C.T

This document discusses a proposed claims processing system for the National Health Insurance Scheme (NHIS) in Ghana. Currently, NHIS claims are processed manually at clinics, making it difficult to store and manage records. The proposed system aims to automate the clinic setup, computerize NHIS claims processing, and improve record keeping. Specifically, it will develop modules for hospital management, NHIS claims processing, reporting, and integrate the systems. The system aims to address challenges faced by Kezia Maternity Clinic in Kumasi and will benefit other health facilities and NHIS stakeholders if successfully implemented.

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1K views3 pages

Garden City University College: Department of I.C.T

This document discusses a proposed claims processing system for the National Health Insurance Scheme (NHIS) in Ghana. Currently, NHIS claims are processed manually at clinics, making it difficult to store and manage records. The proposed system aims to automate the clinic setup, computerize NHIS claims processing, and improve record keeping. Specifically, it will develop modules for hospital management, NHIS claims processing, reporting, and integrate the systems. The system aims to address challenges faced by Kezia Maternity Clinic in Kumasi and will benefit other health facilities and NHIS stakeholders if successfully implemented.

Uploaded by

richardmawuli3593
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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GARDEN CITY UNIVERSITY COLLEGE

SCHOOL OF INFORMATION AND COMMUNICATION TECHNOLOGY


DEPARTMENT OF I.C.T

TOPIC:
NHIS CLAIMS PROCESSING SYSTEM

By

OSBOURNE ADU GYAMFI

NANA BADU ESSIEN

A Dissertation submitted to the School of Information and Communication


Technology, Garden City University College in partial fulfilment for the
requirements for the award of degree of

BACHELOR OF SCIENCE IN COMPUTER SCIENCE

Supervised by

May, 2010
INTRODUCTION:

The National Health Insurance Scheme has come to stay in Ghana. Though the benefits are
enormous, it faces a lot of challenges as well. One of such problems is the claims aspect of
the NHIS.

SYNOPSIS

The clinic currently uses the manual system in their day to day activities. NHIS claims are
also done manually making it a difficult task.

Records are kept manually and it becomes difficult to store those sheets with time.

OBJECTIVES

The following are our objectives:

 To automate the clinic setup


 Computerize the processing of the claims
 And to also improve record keeping

The proposed Claims Processing System we are trying to develop will address the following
areas in our proposed organization setup.

HOSPITAL MANAGEMENT SYSTEM

The automation of the Clinic will be our first task. Areas that would be looked at
include the Out-Patient Department, the In-Patient Department, Maternity and
Records section of the clinic.

NHIS CLAIMS PROCESSING

This module will tackle address issues like the provision of the NHIS service delivery
and the preparation of claim procedures.

REPORTING

The system will print the claim sheet

The system will also print summary reports based on specific schemes.
INTEGRATION: The Hospital Management system will be integrated with the
NHIS Claims Processing System.

PROPOSED SITE OR CASE STUDY FACILITY:


Kezia Maternity Clinic - Kumasi

RELEVANCE TO SOCIETY AND THE NATION AT LARGE:

The system is of real importance to the management and staff of our proposed study facility
due to the fact they really want to automate their operations but have consistently failed to get
a customized system.

If the system is well developed, tried & tested and accepted it will not only serve the interest
of our proposed facility of study but similar operators in the health services industry will
welcome its implementation.

The Stakeholders of the NHIS will really welcome the system and will form the basis for
future applications to be added in the near future.

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