SHA buidling /FILE
The Social Health Authority (SHA) and the Digital Health Agency (DHA) have assured Kenyans that healthcare claims and payments to contracted hospitals under Taifa Care continue to be processed in line with the law and established government systems.
In a joint statement, the two institutions responded to issues raised in media reports concerning the digital claims system supporting Taifa Care.
They said the claims process remains under the responsibility of SHA, while DHA provides the digital infrastructure that enables healthcare facilities to submit and process claims electronically.
The agencies said Kenya's ongoing digital health reforms are intended to support Universal Health Coverage by improving efficiency, accountability, secure patient verification and faster claims processing.
They stated that no private company receives, controls or pays out funds meant for hospitals on behalf of SHA.
According to the statement, SHA is responsible for receiving, reviewing, approving and paying eligible claims to contracted healthcare providers in accordance with the Social Health Insurance Act, 2023.
DHA, it said, supports the digital systems used to facilitate secure electronic submission and processing of claims.
The agencies said the Taifa Care system is supported by integrated digital platforms developed under a government contract with the Safaricom Consortium.
They added that the contract permits the engagement of specialised subcontractors where necessary, in line with Kenya's procurement and contracting laws.
They also clarified that the 2 per cent fee referred to in the media reports is a system service fee provided for under the Digital Health Act, 2023 and related regulations.
According to the statement, the fee supports the digital platform used to process SHA claims electronically, verify patients and healthcare providers, and securely share health information across healthcare facilities.
The agencies said the system helps reduce paperwork, manual processing and delays that would otherwise require additional staff, more time and higher administrative costs for healthcare facilities.
They added that the fee is charged only on claims that have already been approved for payment and is processed automatically within the system.
SHA and DHA encouraged healthcare facilities to submit complete and accurate claims, obtain the required pre-authorisations where applicable, and ensure their facility and banking details are current to support timely processing.
The two institutions said SHA will continue supporting healthcare providers through training, technical assistance and ongoing system improvements aimed at reducing avoidable claim delays and rejections.
They said both institutions remain committed to transparency, accountability and continued engagement with healthcare providers, the media and the public to ensure Kenyans receive accurate information about Taifa Care.
