Provider standards and assessment

LifeCome HMO Nigeria Limited is developing a provider assessment process to support safe and accountable healthcare access after launch.

Proposed assessment areas

Assessment is intended to consider applicable facility and professional licences, regulatory registrations, service scope, clinical staffing, equipment, infection prevention, emergency readiness, record keeping, data protection and complaint handling.

Contractual and administrative readiness

Prospective providers will need to understand the relevant benefit rules, eligibility checks, referrals, authorisation requirements, documentation, agreed fees and claims procedures before providing services under an arrangement.

Service monitoring

Future provider agreements are intended to include appropriate reporting, review of service concerns and cooperation with quality or claims checks. Clinical judgement remains with appropriately qualified healthcare professionals.

Expressing interest

An enquiry is the first step only. It is not approval, accreditation or a provider appointment. Do not send patient records with an initial enquiry.