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Overview

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Page Properties

Country/Region

Nepal

Scheme Operator

Health Insurance Board (HIB) Nepal

Scheme type

National Social Health Insurance

Implemented since

2016

Implementing Partner(s)

HIB, GIZ Nepal, and previously https://openimis.atlassian.net/wiki/pages/resumedraft.action?draftId=835682333 Swiss TPH

Supporting Partner(s)

Financial Assistance: German Development Cooperation

Version

Functionalities used

  • Beneficiary Management

  • Claims Management

  • Claims Review

  • Reports

Coverage

76 77 districts of Nepal

Number of beneficiaries

35,700968,000051

Number of users

7147

Number of health facilities

375

Last update

April 2021November 2022

Scheme Features

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Country/Region

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Nepal

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Scheme type

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Health Insurance Scheme

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Cooperation partner

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Health Insurance Board (HIB) Nepal

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Implementation Support

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Health scheme implemented since

2016

openIMIS Implemented since

2016

Name of openIMIS focal point

 Mr. Suresh Tinkari

Total number of health scheme employees

 -

Total number of employees using openIMIS

7147 

Total number of employees not trained on openIMIS

 -

Number of health insurance products managed by the health scheme and using openIMIS

 3

Product Features

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3,700

Number of households covered

800,000

Number of beneficiaries

,000

Average size of a household

4.6

Household contribution amount

NPR 3500

Individual contribution

-

Average amount paid for a claim

-

Excerpt
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Specifications of the openIMIS used

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Version

Has anything been modified (customization)

What standards are used to code services, items, diagnosis and products

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true
Page Properties
hidden

Three main lessons learned

:

One

Two

Three

Recommendations for Developers' Committee

:

What to improve

What to add

What to remove

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Social Health Insurance in Nepal

Scheme Design

Benefit package

Contribution

Business Processes

Enrolment

Insuree verification

Service provision

Claiming from facilities

Claim review

openIMIS Implementation

Customization

Configurations

Deployment

User base

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Include Page
Nepal HIB Implementation Details
Nepal HIB Implementation Details