NHIMA goes for mandatory claim bills
By George Zulu
THE National Health Insurance Management Authority (NHIMA) has introduced the mandatory issuance of claim bills to National Health Insurance Scheme (NHIS) members.
NHIMA head of public relations King Syachika said the organisation would not leave anyone behind as it provides health claims to beneficiaries.
“The National Health Insurance Management Authority [NHIMA] would like to inform members of the National Health Insurance Scheme [NHIS], stakeholders, NHIMA-accredited healthcare providers, and the public that the authority has introduced a mandatory requirement for all accredited health facilities to issue claim bills to NHIS members whenever they access healthcare services,” he said.
Syachika said the decision was aimed at enhancing transparency, accountability, and trust in the health scheme, while empowering members.
“This initiative is part of NHIMA’s continued efforts to enhance transparency, accountability and trust in the scheme, while empowering members to be more informed about the services they receive under their health insurance cover,” Syachika said.
He said the initiative would be in effect next month, with all health providers directed to issue copies of bills to the NHIS after receiving health services.
“Effective 15th October 2025, it will be mandatory for all healthcare providers to print and issue a copy of the bill to NHIS members after receiving a health service. In accordance with Section 39(2) of the National Health Insurance Act No. 2 of 2018, NHIMA is mandated to implement monitoring systems that safeguard the integrity of the Fund,” Syachika said.
“The new policy will ensure that NHIS members are fully informed of the services rendered and can actively monitor their healthcare consumption. The claim bill will outline the services accessed and the corresponding costs covered by the Scheme. The bill will further enable the NHIS members to monitor and appreciate their health service consumption data.”
Syachika said the move was aimed at promoting transparency, ensuring that members clearly understand the benefits and services received under NHIS.
He said the initiative would also strengthen accountability and encourage providers to submit accurate claims and reduce the risk of billing discrepancies.
Syachika said this would enhance member confidence by empowering members with information that affirms their entitlement to quality healthcare services.
“NHIMA urges all accredited health facilities to comply with this directive. Members of the NHIS are also encouraged to demand their bills after every visit to ensure they remain informed participants in their healthcare journey,” Syachika said.
He said authority remains dedicated to delivering affordable and quality healthcare to all Zambians, in line with its mandate to manage the Scheme effectively and sustainably.
“Remember, by contributing regularly, you will ensure the sustainability of the NHIS and guarantee access to high-quality healthcare services when you need them,” said Syachika.
