- SHA has processed and disbursed the fourth and final batch of eligible claims inherited from the former NHIF.
- The payments cover verified claims valued at KSh10 million and below.
- Healthcare facilities had to complete verification and sign-off before receiving payment.
- Facilities with unresolved queries over their verified amounts will be paid after the issues are addressed.
The Social Health Authority has announced another major step in clearing outstanding claims inherited from the former National Hospital Insurance Fund. SHA said the fourth batch of eligible payments has now been processed and disbursed. The latest settlement covers claims valued at KSh10 million and below.
The announcement was made on Wednesday, August 19, as the authority updated healthcare providers on the status of the inherited claims. Only claims that had gone through the required verification process were included in the latest payment. Facilities were also required to confirm and sign off on the verified amounts before the funds could be released.
The move follows the government’s wider effort to settle pending NHIF obligations following the transition to the SHA system. In April, the Ministry of Health said KSh4 billion had been allocated to begin settling verified claims between KSh0 and KSh10 million. The ministry also reported that SHA had achieved a 74 per cent claims settlement rate at the time.
Who qualified for the latest payment?
SHA explained that the latest disbursement was specifically targeted at healthcare facilities that had completed the verification and sign-off requirements. This means providers whose claims were still undergoing review were not included in the payment. The authority said the process was designed to ensure that only eligible and confirmed claims were settled.
Facilities that had questions about the amounts verified for payment will have to wait before receiving their funds. SHA said those concerns must first be resolved before the affected providers complete the required sign-off. Once that process is concluded, the outstanding payments can proceed.
The clarification is important for facilities that may not have seen their payments included in the latest batch. Their exclusion does not necessarily mean the claims have been rejected. Instead, SHA says the outstanding issues must be addressed before the claims can move to payment.
The settlement of inherited NHIF claims remains part of the broader transition to Kenya’s new health financing system. SHA took over key responsibilities following the replacement of NHIF, leaving the government with the task of addressing claims accumulated under the former fund. The process has involved verification of claims and confirmation by healthcare providers.
SHA has also published information on larger outstanding claims. In July, the authority said it was seeking budgetary support from the National Treasury for verified claims exceeding KSh10 million per facility. That category covers 451 healthcare facilities and is separate from the latest payments for claims of KSh10 million and below.
The distinction means healthcare providers with larger outstanding balances should not assume they are covered by the fourth batch announced on August 19. The latest payment specifically concerns eligible claims at or below the KSh10 million threshold. SHA’s position is that unresolved verification issues must also be settled before affected providers can be paid.
Healthcare facilities that disputed or sought clarification on their verified figures have been given a clear condition for payment. SHA says their concerns must first be resolved through the verification process. They will then be required to complete the necessary sign-off before their payments are released.
The process is intended to reduce disputes over the amounts being settled. It also gives providers an opportunity to address discrepancies before accepting the verified figures. For facilities still waiting, completing the outstanding requirements will therefore be important in determining when they receive their money.
The latest announcement brings the fourth payment batch into focus as SHA continues working through inherited NHIF liabilities. While the authority has cleared another group of eligible claims, providers with unresolved matters or claims above the stated threshold remain subject to separate processes. The government is expected to continue providing updates as the settlement exercise progresses.
