Certification of Health Facility

CONDITIONS FOR APPLICATION FOR CERTIFICATION;

The following are conditions for certification of a Health Facility:

a) The facility must be registered by the Ministry responsible for health matters in Tanzania mainland or Zanzibar, supported by a valid registration certificate and an official letter from the office of registrar of respective authority in which the facility is registered,

b) The facility must comply with all regulations under the Ministry responsible for health matters

c) The facility must be within categories approved by the Fund to be certified,

d) The facility must accept and observe the payment system adopted by the Fund (e.g. fee-for-service, capitation or a combination of both),

e) The facility must comply with all procedures set by the Fund regarding service provision, claiming and verification.


CERTIFICATION PROCEDURES

a) All applications should be submitted in writing to NHIF Regional Offices

b) All applications are approved by NHIF Management


REASONS FOR DE-CERTIFICATION OF A HEALTH FACILITY

A facility may be de-accredited due to the following reasons:

a) The service provider does not adhere to guidelines provided as per protocols issued by the Ministry responsible for health matters;

b) The Service Provider fails to provide service according to terms and conditions of the Agreement between the Fund and the service provider and in the required standards;

c) The facility is found not to be registered or is de-registered by the Ministry responsible for health matters or regulatory authority under the Ministry.

d) The Fund, in its sole discretion and for any reason whatsoever decides to terminate this Agreement.


AUTOMATIC TERMINATION OF CERTIFICATION

The Service Agreement shall be terminated automatically if:

a) At the end of certification period if there is no application for its renewal,

b) There is transfer of ownership of the facility to a third party; or

c) There is transfer of Health Provider’s place of business

d) Failure to meet the Standard Health Facility Guidelines set by the Ministry responsible for health matters

e) Any felony conviction under the Government law relating to interference with service provision,

f) Any proved fraudulent tendency