Feature Name
NHIS Improvements
Module
Laboratory
Navigation Path
Other Configurations → Setup Credit Agency
Walk-In
Perform Investigation
Claims Management → Unverified Claims
Claims Management → Verified Claims
Claims Management → Print
Feature Overview
The NHIS Improvements enhance insurance configuration, subscriber verification, and claims processing in LabManager. Users can configure NHIS and private insurance agencies, verify subscribers during walk-in billing, perform investigations, process claims, and print NHIS claim forms.
Feature Behavior
NHIS and private insurance agencies can be created under Setup Credit Agency.
NHIS agencies support additional branch-specific configuration.
Insurance verification is available during walk-in billing.
Ghana Card and NHIS Membership Number are supported for NHIS verification.
Manual CC Code and HIN entry is available when NHIS verification cannot be completed online.
Insurance details are populated automatically during billing.
Completed investigations can be verified and printed as NHIS claims.
Verified NHIS subscribers receive an SMS notification after successful verification.
How to Use:
Configure an Insurance Agency
NHIS
Navigate to Other Configurations → Setup Credit Agency.
Click New.
Enter the Credit Agency Name, select the Payment Type, and enter the Discount.
Click Save.
Click the Settings (Gear) icon.
Enter the NHIS configuration details, including:
Scheme Name
Health Facility Code
API Key
API Secret
Provider Type
Provider Class/Level
Insurance Officer's Name
Admission Option
Validation Option
Auto Provider Service
Officer Signature
Click Save.
Private Insurance
Navigate to Other Configurations → Setup Credit Agency.
Click New.
Enter the Insurance/Debtor Name.
Select the Payment Type.
Enter the Discount, if applicable.
Click Save.
Create and Verify an NHIS Patient
Open Walk-In and create a new patient.
Select NHIS as the insurance agency.
Choose either:
Ghana Card, or
NHIS Membership Number.
Enter the required insurance details and save the patient.
Complete the billing information.
Under Insurance Verification Details, click Verify.
Complete the subscriber verification.
Search for the required investigation(s) and create the test.
Create a Private Insurance Request
Open Walk-In and create or select a patient.
Select the configured Private Insurance as the insurance agency.
Complete the billing information.
Search for the required investigation(s).
Click Create Test.
Manual NHIS Verification
Heads up: An unknown or invalid NHIS or Ghana card number will not verify or generate a CC code or HIN.
If online verification is unavailable, enter the CC Code and HIN manually.
Continue creating the investigation request.
Perform and Verify Claims
Navigate to Perform the investigation
Select or search for the patient test and enter the results, click Save, and done to complete the test.
Navigate to Claims Management → Unverified Claims.
Review the patient details and investigations.
Add additional investigations if required.
Click Verify.
Confirm the claim appears under Verified Claims.
Print NHIS Claims
Navigate to Claims Management → Print.
Select the print type PDF
Select the patient to Print Selected or choose Print All to print all claim forms for a Selected Period.
Preview and print the NHIS claim form..