The Social Health Authority (SHA) has started verifying pending claims inherited from the defunct National Hospital Insurance Fund (NHIF), paving the way for payment to healthcare facilities.
The latest exercise targets claims worth Sh10 million and above per facility.
SHA said the exercise will help establish whether the claims are genuine and meet the requirements for payment.
“SHA has commenced the surveillance and verification of pending defunct NHIF claims of KES 10 million and above,” the authority said in a notice.
Healthcare providers affected by the exercise have been asked to review the list issued by SHA and prepare the documents required during verification.
The documents include invoices, service delivery records and claim submission records.
The move comes weeks after the government released Sh4 billion to begin clearing verified NHIF claims worth Sh10 million and below.
The payment programme is expected to benefit 3,527 healthcare facilities across the country.
SHA had earlier required facilities with claims in this category to sign off on the amounts verified before payments could be released.
The authority also gave hospitals an opportunity to raise concerns over the amounts allocated to them before the payment process was completed.
The latest verification now shifts focus to facilities with larger outstanding claims.
SHA had said it was seeking funding in the 2026/27 financial year to settle verified claims exceeding Sh10 million per facility.
The funding request covers 451 healthcare facilities with outstanding claims in the higher category.
The claims are part of the debts left behind after NHIF was replaced by SHA under the government’s new health insurance system.
The unpaid bills have continued to put pressure on healthcare providers, with hospitals demanding payment for services provided during the NHIF era.
The government has previously said the inherited NHIF debt runs into billions of shillings and would be cleared progressively after verification.
Health Cabinet Secretary Aden Duale had also said the government would prioritise verified claims of up to Sh10 million before addressing the larger outstanding bills.
The latest exercise could therefore offer relief to hospitals that have waited for years to recover money owed by the former insurer.
However, facilities with claims above Sh10 million will have to wait for the verification process to be completed before payments are made.
SHA has urged the affected healthcare providers to have all supporting documents ready to facilitate the exercise.
The authority is expected to use the verification results to determine the amount payable to each facility as it works towards settling the remaining NHIF liabilities.
