SHA CEO Mercy Mwangagi/FILE
The Social Health Authority (SHA) has given healthcare providers until July 31 to submit queries regarding verified defunct National Hospital Insurance Fund (NHIF) claims valued at Sh10 million and below.
In a notice issued on Friday, SHA CEO Mercy Mwangangi said the window is open to healthcare providers that have not yet completed the sign-off process for the verified claims and wish to seek clarification on the amounts communicated by the authority.
Facilities with concerns have been asked to submit written requests for clarification to the authority for review.
"Healthcare providers that have not yet completed the sign-off process for verified defunct NHIF claims valued at Sh10 million and below may submit any concerns or requests for clarification to the Authority for review," the notice reads.
According to Mwangangi, the submissions should be sent to the authority through the official email address provided and must contain key details to facilitate the review process.
"Facilities seeking clarification on the amount communicated are requested to send a written submission to directorbenefits and [email protected] by Friday, 31 July 2026," Mwangangi said.
These include the facility's name, former NHIF facility code, pending claims amount, relevant claim reference numbers and a clear explanation outlining the grounds for the concern.
Healthcare providers have also been directed to attach supporting documents, including claims statements, claims reconciliation statements and any other evidence relevant to the claims under review.
SHA said the information submitted will enable the authority to verify the issues raised before communicating its findings to the affected facilities.
The authority further indicated that all submissions received by the July 31 deadline will be reviewed within three weeks after the close of the exercise.
The outcome of each review will then be communicated directly to the respective healthcare providers through the appropriate channels.
The notice forms part of the ongoing process to resolve outstanding claims inherited from the now-defunct NHIF following the transition to the Social Health authority.
The authority reiterated its commitment to ensuring that the review process is conducted fairly and transparently.
"SHA remains committed to ensuring that the review process is fair, transparent, and based on verified claim records," the notice states.
The latest directive comes weeks after the State announced the release of Sh4 billion to begin settling verified outstanding claims owed to healthcare facilities by the defunct NHIF, with SHA announcing a nationwide sign-off exercise to pave the way for payments.
In a notice, SHA said the funds will be used to settle verified claims amounting to Sh10 million and below owed to eligible healthcare facilities.
The authority said the payment programme will benefit 3,527 healthcare facilities across the country.
"Eligible healthcare facilities will be required to execute sign-off agreements confirming that their verified defunct NHIF claims have been fully settled," the authority said.
