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Overview

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

Supporting Partner(s)

Financial Assistance: German Development Cooperation

Version

Functionalities used

  • Beneficiary Management

  • Claims Management

  • Claims Review

  • Reports

Coverage

76 districts of Nepal

Number of beneficiaries

3,700,000

Number of users

7147

Number of health facilities

375

Last update

April 2021

Scheme Features:

Country/Region

Nepal

Scheme type

Health Insurance Scheme

Cooperation partner

Health Insurance Board (HIB) Nepal

Implementation Support

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

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:

Number of households covered

800,000

Number of beneficiaries

3,700,000

Average size of a household

4.6

Household contribution amount

3500

Individual contribution

-

Average amount paid for a claim

-

Specifications of the openIMIS used:

Version

Has anything been modified (customization)

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

Three main lessons learned:

One

Two

Three

Recommendations for Developers' Committee:

What to improve

What to add

What to remove













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