Regulator Warns HMOs On Patient Waiting Hour

The National Health Insurance Authority has mandated the Health Maintenance Organisations (HMOs) to adhere strictly one hour patient waiting time limit to improve health service delivery.

The Managing Director and CEO of Ultimate Health Management Services, Otunba Lekan Ewenla, disclosed this during the firm’s 14th annual general meeting held in Abuja on Thursday, noting that the directive aims to address widespread complaints regarding prolonged delays and neglect at health facilities

Ewenla, who is a former governing council member of the National Health Insurance Scheme, said the mandate came from the National Health Insurance Authority following a spike in complaints from enrollees about prolonged delays and neglect at health facilities.

“Too often, patients spend the entire day at hospitals before being seen. This is unacceptable. The NHIA has now directed that the maximum waiting time for any patient under the health insurance scheme must not exceed one hour before they receive medical attention at their chosen healthcare facility,” Ewenla said.

The MD linked the NHIA’s role in the health sector to the regulatory functions of the Central Bank of Nigeria in banking and PENCOM in pensions, emphasizing its responsibility to enforce standards, monitor providers, and protect patient rights.

He also noted that in swift response to the NHIA directive, Ultimate Health Management Services confirmed that it has not only complied but has also surpassed the new benchmark0

“Today, our average waiting time is just 10 minutes, and we are working to reduce it further to five minutes,” Ewenla said.

According to him, the firm has deployed robust health management software and introduced a pre-booking system, allowing patients to notify the HMO in advance of their intended hospital visit. The HMO then contacts the hospital to prepare for the patient’s arrival.

“We even place reminder calls to the hospital on the morning of the patient’s visit. This is in line with global best practices. Healthcare should not be approached casually,” he said.

Ewenla further stressed that quality healthcare is a fundamental right, and health insurance is the gateway to accessing that right effectively.

He also pointed out that the health expert disclosed that Ultimate HMO has launched an initiative, targeting Nigerians in the diaspora who wish to support the medical needs of their ageing parents and loved ones back home.

“Many Nigerians abroad send money back home for healthcare, but this one-off approach often fails due to lack of follow-up care. We’ve created a system that allows diaspora Nigerians to pay a fixed premium and enroll their dependents in a structured health insurance plan,” Ewenla explained.

He further explained that the pilot has already begun in the United States, where he recently held talks with the Nigerian Consulate in Atlanta, Georgia. He added that the outreach has extended to Nigerian-run churches, mosques, and grocery stores.

“We’re seeing growing interest from the diaspora, and we are pushing for regulatory backing to ensure wider enrollment and compliance,” he said.

Ewenla, however, pointed out that attitudinal change among Nigerians remains critical to success, citing a general lack of respect for systems and rules.

“We all see how Nigerians disregard simple traffic laws. The same attitude reflects in how we treat healthcare systems. That’s why we’re working closely with the government and regulatory bodies to change this narrative,” he added.

Also speaking at the AGM, the Board Chairman of Ultimate Health Management Services, Mrs. Angela Ajala, emphasized the need for HMOs to prioritize patient welfare and warned against the growing trend of delayed claims settlements by some organisations.

“We take the health and satisfaction of our enrollees very seriously. At Ultimate HMO, we ensure prompt settlement of claims because that’s the backbone of our service delivery,” Ajala said.

She further urged stakeholders in the healthcare sector to embrace innovation and adapt to emerging challenges, including the rise in mental health needs, telemedicine, and care for children with special needs.

Regulator Warns HMOs On Patient Waiting Hour is first published on The Whistler Newspaper