NHI TIGHTENS MEDICAL VISITS POLICY

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The National Health Insurance (NHI) will be talking to health care providers in an outreach series of meetings titled ‘pop up visits.’ These meetings are geared at clearing up misconceptions, addressing matters related to the NHI three visit policy and also discuss noted trends.

The announcement about the visits was made by Manager of Beneficiary Advisory Services Cassandra Lewis in a video announcement that was released recently by NHI. Lewis explained that in addition to the discussion of trends and policies NHI is hoping that the visit will strengthen its relationship with the providers.

“It’s about building a stronger relationship with our providers. We wanted to see how best we can meet with them and discuss certain policies that we have just recently introduced at National Health Insurance as well as their providing us with some guidance in some of the experience they have been having for the past couple of years,” Lewis stated.

Since it was announced in May this year, the three-visit policy of NHI has been heavily discussed and Lewis said that she anticipates having a conversation on the matter with healthcare providers: “Of course, we will be discussing the three-visit policy. We will also be seeing some of the trends that we have been happening for the past two years or so, and we will also want to stop some of the misconception that is being put in the public with regards to NHI. We want the information coming out of the provider’s officer or coming from our office to be as accurate as possible,” Lewis stated.

In May this year the National Health Insurance announced that it implemented a policy to places a three-time cap on doctor visits on the same diagnosis within 30-day-timeframe.

Under this policy persons using NHI are allowed a primary visit with a medical practitioner, followed by a maximum of two follow-up visits for a specified diagnosis within 30 days.

In that announcement Lewis was quoted saying: “The goal of the policy change is to ensure that all beneficiaries receive quality care, with a view to improved healthcare services throughout the Virgin Islands, along with adequate fiscal responsibility of the NHI fund.”

Manager of Beneficiary Advisory Services further stated that the policy has some flexibility: “If further visits are required for the same diagnosis, NHI must be notified in this regard and additional visits may be granted on a case by case basis.”

Lewis further stated that the National Health Insurance reserves the right to recommend a second opinion or referral to a specialist for the beneficiary of deemed necessary or if one was not previously sought by the practitioner providing service.

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