The government's ambitious plan to provide universal healthcare through the Social Health Authority (SHA) has seen significant progress in its first week.

According to a statement by the Ministry, as of Sunday, a total of 12,704,548 Kenyans have registered for the Social Health Insurance Fund (SHIF), exceeding expectations.

This number includes those previously enrolled in the National Hospital Insurance Fund (NHIF), which has been seamlessly transitioned to SHA under Legal Notice No. 147 of 2024.

While registration remains ongoing through USSD code *147# and web portals (www.sha.go.ke or www.afyayangu.go.ke), authorities have noted a trend of beneficiaries neglecting to register dependents.

They urge everyone to include dependents during registration to ensure their access to healthcare services.

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Early Glitches Resolved, E-Claims System Operational

The rollout wasn't without initial hiccups. The SHA E-Claims system, crucial for processing claims from healthcare providers, encountered challenges related to member verification and claims processing.

However, the government has addressed these issues, ensuring the system is now up and running.

Over 10,000 healthcare providers have been trained on the system and received login credentials. Additionally, a dedicated Provider Portal User Onboarding Form has been launched for those who have yet to gain access.

Importantly, the Health Insurance Claims System (HICS) from the defunct NHIF remains operational to verify members, manage ongoing claims under pre-existing enhanced schemes, and handle hospital discharges that occurred before October 1st, 2024.

Contracting Healthcare Providers: Ongoing Process

While all public hospitals from Level 2 to 6 have been successfully contracted and are offering services to SHIF beneficiaries, private and faith-based facilities are still in the process.

By Sunday, 1,442 such facilities have signed contracts, with a slight downward revision from previously reported numbers due to duplicate entries.

A comprehensive list of contracted facilities, categorized for ease of access, is available on the SHA website.

These categories include government facilities, private and faith-based facilities and facilities offering specialized care for cancer and renal diseases.

Following discussions with relevant associations, all remaining private and faith-based facilities are expected to have finalized contracts by Tuesday.

However, they have committed to uninterrupted healthcare services for SHIF beneficiaries during this interim period.

Addressing Pending Bills and Transition Challenges

Authorities have acknowledged outstanding bills owed to healthcare providers under the defunct NHIF.

A joint committee, chaired by the Principal Secretary of the State Department for Medical Services, will be established to verify these claims.

Additionally, the government has pledged to prioritize settling bills arising during the transition period, with regular consultations with healthcare providers to ensure a smooth process.

Uninterrupted Access to Healthcare: A Top Priority

The government reiterates its commitment to a seamless transition for all Kenyans.

They emphasize that no registered SHIF beneficiary will be denied access to healthcare services. For support and assistance, individuals can reach out to the SHA customer experience centre at 0800 720 601.

This rollout marks a significant step towards universal healthcare in Kenya, with the initial phase exceeding expectations.

As the program continues to evolve, Kenyans can expect improved access to quality healthcare services.