ILO External Collaboration Contract: NSSF Health Data Claim Analysis.

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Bidding

Dear Bidder, The ILO is looking for an individual to undertake work as an External Collaborator. Below is a summary of the work to be performed: The objective of the consultancy is to undertake an analysis of NSSF claims, to understand expenditure trends, identify the indicators sensitive to possible anomalies and formulate recommended measures for efficiency improvements. The process with involve the relevant NSSF staff for data collection and analysis with a purpose of transferring data analysis knowledge and skills to apply it in the actual situation. The NSSF claim management process involves healthcare providers preparing and submitting batched claim forms monthly, initially through the Health Service Provider Information System (HSPIS) portal to generate a batch number, followed by the submission of files and scans to the relevant NSSF branch office. The NSSF offices then review the claims and claims that meet minimum standards are forwarded for payment, while the rejected claims lacking documentation can be resubmitted or for the providers to appeal. The analysis will enable a deep understanding of health care spending and care seeking behaviour of the NSSF members and develop measures to detect anomalies suggesting possible misuse of fund or fraud, thereby improving the financial performance and credibility of the NSSF scheme. Interested candidates are invited to submit a narrative proposal (including methodology and work plan) and a financial proposal with daily fee follow the instructions attached to consult the detailed terms of reference and other relevant information in the ILO e-sourcing platform. Please submit your proposal before the specified deadline.

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