Namibia Dental Association halts NHP patient treatment over unpaid claims backlog

This decision affects NHP, which has over 40,468 principal members and 83,048 beneficiaries. The NDA, along with the Namibian Society of Physiotherapy NSP, attributes the issues to Universal Care, which took over as administrator from Medscheme in April. NDA president Johann Archer stated that dentists will cease treatment until the backlog of unpaid claims is cleared, and may encourage patients and employer groups to switch to other medical aid funds.

Archer alleges that Universal Care is uninformed about the Namibian market, rejects claims with little explanation, and makes irrational requests for motivations for basic dental procedures, leading to significant financial strain on practices. He also warned that these challenges could jeopardize patients' lives due to deteriorating conditions and dental emergencies. NHP spokesperson Tunohole Mungoba indicated that NHP would comment after a scheduled meeting with the NDA.

NSP chairperson Christiane von der Heiden also reported a high number of unprocessed claims, misdirected authorizations, and non-functional communication channels since Universal Care's transition, urging NHP to investigate and resolve these issues promptly.