AON Minet Set To Go Biometric In Verification. Check Out New Service Providers Per County For 2022. Check Out The Changes.
The teachers medical insurance provider has issued new terms for its teachers and dependants seeking medical services in various facilities begining 1st February 2022.
Among the new rules, AON Minet, which covers more than 300,000 teachers on Teachers Service Commission (TSC) payroll, will no longer use code verification in all facilities it listed.
In the new changes Minet will use biometric verification for teachers and their dependants in its medical service providers to curb unethical practices.
Minet also says referrals will be through TSC offices, Bliss hospitals or referral and teaching hospitals if one needs a specialized check up.
Yesterday the insurance sent short messaging services to teachers informing them of the changes it plans to roll out.
“Dear Mwalimu, expect changes to the panel of service providers from 1st Feb 2022. Dial *202*06# or visit the link https://bit.ly/TMServiceProviders to view the updated list for year 2022,” reads SMS sent to teachers.
The medical cover cost TSC Sh9 billion in 2019, Sh12 billion in 2020 and Sh14 billion last year.
Two months ago AON Minet blacklisted at least 20 hospitals for engaging in unethical practices, exposing dubious ways the health facilities use to defraud the multibillion-shilling teachers’ medical scheme.
Teachers and their dependents also came into sharp focus as it was revealed that they collude with hospitals to fleece the TSC of the insurance cover.
The vices ranged from making fake claims, overcharging members, listing fake ailments to impersonation.
A brief by Minet Kenya, the firm contracted by TSC to manage the scheme, listed at least 10 ways that teachers, their dependents and hospitals use to fleece the scheme.
They include impersonation, billing for services not rendered, billing for conditions not covered under the scheme, double billing of medical expenses and falsification of the length of stay of patients in hospitals.
Incorrect reporting of diagnosis or procedures, false and unnecessary prescription of drugs, abnormal utilisation of services, bribery and unethical inducement are also ways used to cheat.
In addition to these, Minet Kenya Chief Executive Sammy Muthui said many facilities have been blacklisted and others presently put under investigations for abusing the seven-day rule.
Under this rule, Muthui said if a patient is treated for a condition and within seven days returns to the hospital to be cared for over the same ailment, they should not be charged.
“The member should never be asked to pay out of pocket. But we have had cases where this rule has been breached and patients asked to pay money or turned away. This is fraud and we take it seriously,” he said.
Below are the new service providers listed by AON Minet Kenya