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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
Health Insurance Scheme
Cooperation partner
Implementation Support
Health scheme implemented since
openIMIS Implemented since
Name of openIMIS focal point
Mr. Suresh Tinkari
Total number of health scheme employees
-
Total number of employees using openIMIS
Total number of employees not trained on openIMIS
Number of health insurance products managed by the health scheme and using openIMIS
3
Number of households covered
800,000
Average size of a household
4.6
Household contribution amount
3500
Individual contribution
Average amount paid for a claim
Has anything been modified (customization)
What standards are used to code services, items, diagnosis and products
One
Two
Three
What to improve
What to add
What to remove
Enrolment
Insuree verification
Service provision
Claiming from facilities
Claim review
Manuals