The mandate of the department is basically to purchase healthcare services on behalf of the enrollees and also regulates the activities of the providers through its various units. The units in the Department includes Accreditation, Claims management, Underwriting & Actuarial services, Quality Assurance & Enforcement. The unit is also responsible for grievance redress services. There are grievance redress registers in Place. The register contains information about the complainant, the complaint (time and date the incidence took place) and supporting documents if any. The beneficiaries, Providers and others can complain if dissatisfied with the services rendered. The complaint is to be channeled to the Executive Secretary through the department in written. Calls can be put through to the enforcement officer or call center agents.

The Claims unit is dedicated to ensuring the efficient, accurate, and timely processing of all health insurance claims submitted by healthcare providers. Our team consists of experienced professionals ranging from a Doctor, Pharmacists, Nurses/Midwives, Community Health Officer and Medical Lab scientist specializing in claims processing, verification, and dispute resolution. We collaborate closely with healthcare providers to facilitate smooth claim submissions and address any issue(s)that may arise. Our primary goal is to ensure that providers receive timely reimbursements and beneficiaries have access to necessary healthcare services without undue financial burden.