Medical insurance firms cut links with Nairobi Women’s Hospital

Nairobi Women’s Hospital. PHOTO | FILE | NATION MEDIA GROUP

What you need to know:

  • Old Mutual further warned that cash payments to the hospital may not be eligible for reimbursement.

  • Leaked conversation shows how the hospital bosses set daily targets for the number of patients that should be admitted to the facility.

All health insurance providers have suspended services at Nairobi Women’s Hospital.

Jubilee, Britam, AAR, Old Mutual and CIC Group said they would no longer reimburse both inpatient and outpatient claims in any of the hospital branches.

In a statement signed by Old Mutual General Manager Health Business Jeff Ogollah, the health provider, notified its clients that credit services at The Nairobi Women's Hospital had been suspended effective from February 5, 2020.

CASH PAYMENTS

 "We request that you seek services from alternative hospitals in our provider panel," the health insurance provider asked its clients.

The firm further warned that cash payments to the hospital may not be eligible for reimbursement.

In a statement, the CIC Group also said it had suspended services at the hospital effective February 5, 2020 due to some administrative concerns.

This was the case with Britam. “Due to administrative concerns, we wish to notify you that Britam has suspended credit services at the Nairobi Women’s Hospital. We request you to seek services from alternative hospitals in our provider panel,” Britam Insurance said in a statement.

The news comes a day after the hospital’s board of directors issued a statement saying that it has commenced an internal probe into claims.

The board said it is also cooperating with the Kenya Medical Practitioners and Dentist Council which is also conducting an independent scrutiny into the allegations.

GENERATE REVENUE

“We have noted with a lot of concern reports appearing in various media platforms in the recent past suggesting that there is some systematic approach by the hospital to unfairly generate revenue from patients.

“Although we don’t believe this is the case, and in fact it is antithetical to our foundational principles, we take these allegations very seriously and are conducting an internal review as well as cooperating with the Kenya Medical Practitioners and Dentist Council as they carry out their independent review,” said the medical council CEO Dr Eva Njenga.

Dr Njenga said the new council members would investigate the allegations and compile a report in a months’ time. 

Leaked conversation shows how the hospital bosses set daily targets for the number of patients that should be admitted to the facility.

ADMISSIONS

The messages show that the revenue, commissions, admissions and discharge were being monitored hourly, every day, and day and night by CEO Dr Felix Wanjala.

In multiple texts covering different days in 2018, the WhatsApp group resembles a trading floor, with Dr Wanjala and his Chief Operations Officer Eunice Munyingi pushing employees to work harder and increase admissions.

On the first day of July, for example, Ms Munyingi wrote in response to the nurse in charge of the hospital chain: “Let us increase speed; two admissions against 13 discharges at this hour is not good.”