SHA has returned to manually filling out claim forms because its new digital management system keeps failing. Hospitals have resorted to using hard copies of claim forms due to the inaccessibility of the Sh 104 billion system.
Now, over 64% of healthcare providers can’t access it, worsening the gaps in patient care. The system is running on an open-source application, causing anxiety about its stability.
The action follows SHA chairman Abdi Mohamed’s announcement that only those who spent their money after September 30, 2024, midnight were eligible for refunds, and he urged all those affected to contact the authority.
SHA Chief Executive Office Elijah Wachira said they would also pay for all outstanding cases where NHIF had given an undertaking before October 1, 2024.
“All patients whose admissions or procedures commenced after 30th September 2024 will have their bills settled under SHA; there is no lacuna,” he said.
Additionally, the CEO reassured patients who had already spent more than the SHA’s approved benefits not to worry.
Every now and then, you will discover that certain procedures have limits that are lower than what a hospital charges. Hospitals are at liberty on many occasions to charge for conveniences over and above the basic treatment,” he said.