The Government of Kenya endeavors to provide the highest attainable standards of care to all Kenyans without incurring catastrophic expenditure. As such we are on day six of the roll out to social health insurance.
First and foremost, we thank all Kenyans who have engaged and supported in the process of transition. We also wish to thank the many Kenyans who have given invaluable feedback on the challenges they have experienced during this transition. We assure you that we are working round the clock to ensure all challenges have been and continue to be addressed.
We wish to update as follows;
Registration — We have as at today 6th October, 2024 registered a total of 12,704,548 members into the Social Health Authority. This number includes verified members who were under the defunct NHIF and who have been transitioned to the Social Health Authority as per Legal Notice No. 147 of 2024. Registration is a continuous process and is ongoing through the USSD or web-based portal on www.sha.go.ke or www.afyayangu.go.ke We have also noted that most beneficiaries are registering but not adding their dependents. We call upon all to add their dependents for them to access healthcare services as well.
Therefore, all Registered SHA Beneficiaries are entitled free access to Primary Healthcare Services under the Primary Healthcare Fund at Levels 2 (Dispensaries), 3 (Health Centres) and select level 4 Health Facilities and Emergency services in all Health Facilities.
Contracting of Health Facilities — All Public Hospitals Level 2 to 6 have been contracted and are offering services to SHA registered beneficiaries. With regard to Private and Faith Based Health Facilities, as at today 6th October, 2024, a total of 1,442 Health Facilities have since returned duly signed Contracts and are therefore offering services to SHA registered beneficiaries. Yesterday, we had reported a total of 1577 Health Facilities Contracted. However, this was an error due to duplication of names of Facilities. The list of all Health Facilities Contracted and offering services is available on the web-based portal on https://sha.go.ke/resources/categoriesL2 and has been segregated as follows for ease of identification and access;
Contracted Government Facilities;
- Contracted Private and Faith Based Facilities
- Contracted Facilities offering Cancer Care
- Contracted Facilities offering Renal Care
Further, following our engagement with Private and Faith Based Hospital Associations today 6th October, 2024, we have agreed that all their Health Facilities shall return duly signed Contracts latest Tuesday, 8th October, 2024. However, they have committed to ensuring continued access to healthcare services to all SHA registered beneficiaries during this transition period.
SHA E-Claims System — It is important to note that during the initial days of the rollout, we experienced challenges on the e-claims portal, particularly on member verification and claims processing. We have since addressed the system challenges and wish to update as follows;
- The E-Claims system is up and running.A total of 10,904 end users have been trained, enrolled and their credentials sent.Services are currently available on the SHA E-Claims Portal.
- For Healthcare Providers who have not received credentials, SHA has circulated a Provider Portal User Onboarding Form. Healthcare Providers are hereby encouraged to fill and submit the onboarding form immediately.
We have also made sure that the Health Insurance Claims System (HICS) operating under the defunct NHIF continues to be in operation for member verification, discharge of patients admitted before 1st October, 2024 and for claims management of the active enhanced schemes whose Contracts have not expired.
- Pending Bills & Bills arising during the Transition — We have agreed with the Healthcare Providers that a joint committee Chaired by the Principal Secretary, State Department for Medical Services, shall be constituted to undertake verification of all pending bills incurred under the defunct NHIF. Further, we have committed to the Healthcare Providers to prioritize the Bills during the Transition period which is from 1st October, 2024. As a result, there shall be frequent consultation with all Healthcare Providers.
We wish to reaffirm our commitment for a smooth and seamless transition to ensure in particular that No Registered SHA beneficiary is denied Healthcare Services. We are available for support and assistance through the Social Health Authority customer experience centre at 0800 720 601.