The Health Cabinet Secretary, Aden Duale, said the Social Health Authority will pay Consolata Hospital Mathari in Nyeri a total amount of KSh400 million by the end of November.
During an appearance before Members of Parliament at the National Assembly on Wednesday, November 5, CS Duale stated that the Level 5 hospital would receive KSh29.3 million in verified claims in the next payment cycle scheduled for November 14.
The coming payment adds to the KSh372 million the hospital has received so far since the rollout of SHA, representing 17,432 processed claims. However, Duale said as of October, the hospital still has a backlog of 4,792 claims that are under review valued at KSh81 million.
He added that the ministry rejected 335 claims valued at KSh14.7 million, while KSh50 million worth of claims were returned for review.
Duale was responding to a question by Mukuruweini MP John Philip Kaguchia, who had sought clarification on an alleged KSh450 million debt owed to the hospital in unpaid claims.
Located along Ihururu Road in Nyeri County, Consolata Hospital Mathari is an important healthcare provider for thousands of inhabitants in Kiganjo/Mathari Ward and other areas.
The faith-based facility is quite vital in the healthcare system within this region, offering 24-hour emergency services, advanced imaging at the Our Lady of Perpetual Help Diagnostic Centre, a modern laboratory, and three fully equipped operating theatres.
Specialist departments include an eight-bed dialysis centre, a chemotherapy wing, and a comprehensive care centre for HIV/AIDS patients.
It also has strong maternity and child health programs, along with ENT, dental, physiotherapy, and counseling services.
Despite its varied service offerings, the hospital has decried delays in the settlement of claims, especially those carried over from the defunct National Health Insurance Fund.
Faith-based hospitals across the country similarly voiced frustrations relating to stalled reimbursements that have threatened service delivery amidst continued treatment of patients.
He further explained that some of the delays were based on “high-value complex claims” for services like dialysis, surgery, and oncology, which needed detailed verification before approval.
He also listed submission issues from providers, including items like missing signatures, incorrect patient details, and low rates of resubmission after corrections.
Ongoing court cases and litigation involving SHA have also slowed the management of claims. However, Duale assured lawmakers that the Authority is addressing the bottlenecks so processing is faster and disbursement on time.
Archbishop Anthony Muheria of the Catholic Archdiocese of Nyeri earlier this year called on the government to release funds owed to faith-based hospitals, warning that continued delays were crippling healthcare delivery.
He said Catholic hospitals countrywide are owed approximately KSh2.5 billion, a backlog that has strained their capacity for quality care.
With the government working on streamlining the new health financing system, hospitals like Consolata Mathari hope the latest payment is a turning point in Kenya’s journey toward efficient and equitable healthcare financing.
