Hoggar Clinic battles NHIA Over defamatory audit report
The Management of Hoggar Clinic at Akatsi in the Volta Region have thrown an open challenge to the National Health Insurance Authority (NHIA), to produce a single piece of evidence to back their claim that they met them before coming out with a supposed verification and clinical audit report, which sought to indict the facility.
The Medical Director of the clinic, Dr Stephen Kudjo Hoggar, said, “It is simply not true that any exit conference was held between members of your audit team and the management of Hoggar Clinic to discuss any matter.”
The clinic has therefore challenged the audit team of the Authority, to “provide a list of the members of the management team of Hoggar Clinic that sat with them, and also produce a copy of the memo signed by both sides, authenticating the holding of any exit conference on the matter.”
This is in regard to certain alleged malpractices, which were found in a supposed verification and clinical audit report by the Authority, released sometime last year.
Dr. Stephen Kudjo Hoggar, who travelled all the way from Akatsi to the offices of The Chronicle in Accra in defence of his clinic, noted with concern that even though the Authority was yet to receive his outfit's explanation over claims to the findings made against the facility, it had not only imposed sanctions on it, but had also gone ahead to put the issue in the media.
He accused the Authority of passing judgement before a hearing, a clear case of a breach of one of the cardinal principles of natural justice.
Among other things, the NHIA alleged in its clinical audit that during its visit to the facility, some multiple attendances could not be traced to the patients' folders, while the clinic's medical notes indicated that instead of single visits, the NHIA was billed for multiple visits.
It also alleged that there were some incidences of poly-pharmacy in about half of the claims sampled, while serious discrepancies existed between diagnosis and treatment in almost 80% of the claims sampled.
Meanwhile, Dr. Hoggar claims that the clinic had not been given a copy of the supposed audit team's report detailing the claims forms involved, the diagnosis and treatment sheets involved, the number of samples examined, as compared to the total number of patients seen by the facility, and the period over which the 'incident and discrepancies' occurred, to enable them offer appropriate explanations in order to salvage their image and reputation, which he said, had been badly dented.
In response to a letter dated December 29, 2009 by the Authority, and signed by Dr L. Dsane-Selby, acting Director of Claims Management of the NHIA, Dr. Hoggar noted that on January 11, 2010, the clinical and claims audit was conducted in his absence, since he had travelled to Accra on the day the audit team visited the facility.
According to him, he had travelled to Accra to chase payments for long overdue claims submitted to the NHIA.
Though he was the only person who could adequately explain away the situation, Dr. Hoggar emphasised that when he called the team, which were then on his premises to request for a meeting to discuss the matter, he was not given the opportunity, stressing that the leader of the team, whom he spoke to, told him point blank, “we have no time.”
Dr. Hoggar therefore wondered which management of the clinic the audit team held the supposed exit conference with to discuss 'the revelations' as stated in the Authority's letter under reference.
Under the circumstance, the management of the clinic says it cannot see its way clear to give any explanation to the NHIA on its alleged findings, as requested in the letter under reference.