Lead image for SHA begins verification of Sh10m-plus NHIF legacy claims.
The Social Health Authority (SHA) has begun verifying pending claims of Sh10 million and above owed to Level 5 and Level 6 healthcare providers under the defunct National Health Insurance Fund (NHIF).
In a notice dated August 12, SHA said the medical surveillance and verification exercise had commenced to establish the accuracy, authenticity and eligibility of the outstanding claims before payment is processed.
Healthcare providers affected by the exercise have been directed to prepare documents supporting their claims, including invoices, service delivery records, claim submission records and other supporting documents previously submitted to the former NHIF.
The verification is expected to establish which claims qualify for settlement and the amount payable to individual facilities.
The exercise comes as SHA moves to the next batch of NHIF legacy claims, with the Government having earlier indicated that verification of the larger claims would take place in July and August.
The first phase focused on verified claims of up to Sh10 million, with Sh4 billion set aside for settlement of the debts owed mainly to Level 2, 3 and 4 healthcare facilities.
The larger outstanding claims were estimated at between Sh10 billion and Sh15 billion, according to the earlier plan.