Finance guide

Managing NHIA and HMO claims in a diagnostic laboratory

When a laboratory bills NHIA or private HMOs, the money lost is rarely a single large error. It leaks away in tests that were run but never claimed, or claimed at the wrong tariff.

Where the leakage happens

Typical causes: a test performed but not entered on the claim, a tariff that does not match the payer, and claims that sit unreviewed until they are rejected for lateness. Each is small; together they matter.

Start from the logged test

The most reliable source of what was done is the test log itself. When each logged test can be matched to the right payer tariff, a claim can be prepared from facts the laboratory already recorded.

Watch the shortfall, not just the total

The useful number each month is the difference between what the laboratory expected to recover and what it did. A visible shortfall prompts review while the claims can still be corrected.

Common questions

Vitrio helps you prepare and track claims from your logged tests. Submission follows each payer's own process.

It is part of the Nigeria setup, where this reimbursement model applies.

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