Ensuring that all services provided under the Scheme are in compliance with guidelines for the provision of such services as provided in the guidelines or service protocols.
Development of standards and quality assurance (QA) guidelines.
Defining standards according to guidelines and protocol.
Ensuring compliance with guidelines.
Adjudicating claims from Health Care Providers (HCP).
Ensuring prompt HCP payments.
Ensuring Continuous Quality Assurance (HCPs, Reviews and Inspections/Assessment etc).
Accreditation of Health Care Facilities.
Developing and executing marketing plans for the Agency.
Designing programme on health equity.
Generating revenue using inactive means.
Developing sensitization/Advocacy activities.
Production and/or review of operational guidelines and benefit packages.
Registration of Third-Party Administrators (TPAs).
Enrollment of beneficiaries of the Scheme in collaboration with stakeholders.
Management of call Centre functions and help desk.