The Social Health Authority (SHA) has revised the verification dates for Level 4 hospitals with pending claims from the National Hospital Insurance Fund (NHIF).
The changes affect facilities handling NHIF claims valued at KSh10 million, following an earlier SHA notice issued on September 18.
Affected facilities have been directed to check the revised schedule and prepare the documents required for the verification exercise.
SHA Revises Dates for NHIF Claims Verification
In a notice issued on September 28, SHA informed Level 4 healthcare facilities listed in the revised schedule that their previously communicated surveillance and verification dates had changed.
The authority said the adjustment followed its September 18 communication concerning pending claims arising from the former NHIF.
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SHA has instructed the affected facilities to review the updated list and establish their new dates before preparing for the verification exercise.
In its latest update, SHA said facilities should not rely on the dates in the earlier schedule published on September 18, which was scheduled to commence on September 21, 2026, and included a list of Level 4 facilities who’s outstanding NHIF claims met the KSh10 million threshold.
The original schedule covered facilities across different counties and provided specific dates for the surveillance and verification exercise.
SHA has now asked providers to use the revised schedule when determining when their claims will be reviewed.
Documents Hospitals Must Prepare
SHA has directed affected healthcare providers to have their claim-supporting documents ready for verification on their newly assigned dates.
The earlier verification notice required facilities to provide documentation showing that the services for which they claimed payment had been delivered.
Among the records identified for the exercise are invoices, service delivery documents, claim submission records, and other supporting paperwork previously submitted to NHIF.
The verification is intended to allow SHA to examine and validate the outstanding claims before they can proceed through the claims settlement process.
“Affected facilities are requested to check the attached revised schedule, note their new dates, and have the required claim supporting documents ready for verification,” the statement read.
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High-Value Claims Form Part of NHIF Backlog
The KSh10 million-and-above claims are part of a larger backlog of unpaid obligations inherited from NHIF.
In July 2026, the government released KSh4 billion towards verified NHIF claims of KSh10 million and below, with the funds expected to benefit thousands of healthcare facilities after the required verification and approval processes.
The government is handling higher-value claims through a separate process.
The September verification exercise therefore focuses on claims where each affected facility has outstanding NHIF claims worth at least KSh10 million.
SHA also said it would communicate details on verifying pending claims involving Level 3 facilities separately through its official channels.
The authority has directed affected Level 4 facilities to obtain the revised schedule from its website and note the new dates.
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