Established with a vision to be a leader in the industry, ensuring that every Nigerian has access to qualitative, equitable and affordable healthcare', Clearline International Limited, the premier national health maintenance organization (HMO) in Nigeria has by all standards proven itself as a leader in the health insurance business as it continues to break new grounds in the delivery of quality healthcare services through its various affordable plans.
With over 200(1 healthcare providers across the country and 13 zonal centres, Clearline HMO is readily positioned to provide the generality ofN igerian workers and interested healthcare utilizers the required qualitative and equitable medical attention from hospitals, clinics, pharmacies and other health related professionals at an affordable cost. In a chat with the Managing Director of the company, Dr. Isaac Akinsefunmi Akintunji, the seasoned medical practitioner described quality healthcare service as appropriate medical services being given to the populace by qualified medical personnels at a reasonable price. "There is a negotiation between the HMOs and the providers on an agreeable tariff. Hitherto, when people go to hospitals they can be charged anyhow at the discretion of the healthcare providers but with health insurance, enrollees pay what is commensurate with the services provided. At Clearline, all the basic ailments anyone could encounter are covered in our plans. We believe there is no health issue that cannot be covered in as much as the appropriate premium is paid except for chronic ailments and malignancies such as cancer that are not covered. We have plans that cover eyes treatment, Caesarean sections and other surgeries which are provided at affordable prices", he informed.
Though the health insurance business can be described as emerging due to its low acceptability rate among Nigerians, Akintunji explained that the business is improving as more people are becoming aware of the importance of health insurance, however, he emphasized on the need for government at all levels to snake it compulsory for all Nigerians. According to him, "The industry is growing but at a slow progression. The federal government has set a good example by ensuring that all federal civil servants are enrolled on the scheme. We are very hopeful that sooner than later , a higher percentage of the populace will come on board because the awareness has increased. I think the government should make it compulsory for all Nigerians irrespective of their income, quality healthcare cannot be free in its entirety, so everyone should be made to contribute a token into the scheme. Government should also make provisions for those who cannot contribute especially the aged just as it is done in advanced countries because health insurance is the cheapest way of accessing healthcare anywhere in the world."
Corroborating him, Executive Director for Operations, Dr. Babatunde Ladele explained that the fact that health insurance is voluntary is a big challenge to the industry, "Health insurance is not like the general insurance where claims are paid when incidents occur, in health insurance you pay the provider ahead even when the enrollee has no cause to visit the provider, but if more people are enrolled into the scheme, it will be better for the industry. There is also the cultural belief among Nigerians that insurance brings catastrophe which makes it a bit difficult to market, but what we are saying is that people should make prepaid arrangements in form of health insurance to cater for health issue that may arise at anytime. Some people may not have money to visit the hospitals when they are sick but if they have an health insurance plan, they can easily walk into a hospital and get treated without having to pay. That is why we have affordable healthcare plans at Clearl ine to cater for various health needs. We have a network of healthcare providers across the country. and our enrollees can visit any of these providers nearest to theft. We don't'-look for excuses to pay claims because we value our integrity, so we react promptly in paying claims", he added. On how health insurance can be used to address the issue of infant and maternal mortality, Dr. Akintunji explained that HMOs are not just operating for curative treatments but also give information on how certain diseases and sicknesses can be prevented. "Lack of knowledge and information accounts for most cases of infant and maternal mortality and that is why we are urging Nigerians to embrace health insurance. At Clearline, we organize health weeks for ministries and companies that have enrolled with us to enlighten them on health issues and we also send health related newsletters to our enrollees via email because we believe it is part of our responsibility to enlighten them on health issues. If more pregnant women enrol to the scheme, it will go a long way at reducing infant and maternal mortality, he said.
To ensure that the enrollees are getting what they duly deserve from the providers, Clearline HMO hOlds quarterly meeting with the providers, companies and enrollees to assess the performance of the scheme which according to Akintunji has helped the company discover grey areas in the scheme. In addition to that, the company sends out questionnaires to enrollees to get feedback from them and it also operates a 24 hour call centre through which enrollees and providers can reach the company. "We have come a long way in the industry and we want to continue to be at the top, so it becomes important for us to improve on our services as the days pass by", the amiable CEO added.
Source: The Nation News
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