SHA Chief Executive Officer Robert IngasiraThe Social Health Authority has affirmed that it reimburses healthcare providers monthly, stating that it has disbursed Sh5.1 billion for Social Health Insurance Fund (SHIF) claims this week.
The figure brings the total amount paid since the rollout in October 2024 to Sh18.29 billion. “This does not include claims currently undergoing clinical review and reconciliation,” SHA said in a statement.
It urged facilities that have signed contracts and received SHA payments to continue providing services while the NHIF debt resolution process is ongoing.
To date, SHA said it has disbursed Sh1.3 billion to primary healthcare facilities; these are all Level 2, 3 government facilities and select private Level 4, with 51 per cent allocated to private providers.
“Payments are processed fairly and promptly upon claim verification,” it said.
SHA noted that in the first quarter, NHIF data was used for payments.
“Going forward, payments will be based on actual data from new SHA registrations,” the authority said.
SHA added that it is currently compiling returns from healthcare providers to facilitate the release of funds for the second quarter, with payments expected by the end of the month.
“To ensure an efficient payment process, healthcare providers are urged to submit their Quarter 2 returns for FY 2024/2025 promptly. Timely submissions enable clinical reviews, reconciliation, and fund disbursement,” it said.
To enhance efficiency in claims processing, the authority said training on the Primary Health Care (PHC) reimbursement model will be conducted for all facilities starting February 27, 2025.
SHA said it is remains committed to providing healthcare services in collaboration with county governments and healthcare providers across the country.
“We wish to inform the public that primary healthcare services are available at all Government healthcare facilities free of charge, with no limits, as long as one is registered with SHA,” it said.
It added that the list of contracted healthcare providers is available on the SHA website, and that members can also access this information at its branches and Huduma Centres nationwide. “We have contracted 8,600 facilities under SHA.”
