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Submit and track SHA claims (for hospitals and clinics)

Social Health Authority · sources read 2 Oct 2026

Submit each SHA claim on the SHA provider portal within 7 days of the service or discharge, with the claim form, itemised invoice and discharge summary. Fix sent-back claims within 14 days; SHA pays clean claims within 90 days.

Fee
We couldn't confirm a fee from the official page. Check it there before you pay.
How long
SHA pays clean claims within 90 days of receiving them, depending on available funds
Deadline
Submit within 7 days of the service or discharge
Deadline
Resubmit a sent-back claim within 14 days
Deadline
Ask for a review of a rejected claim, with new evidence, within 7 working days
Where
Online on the SHA provider portal (portal.sha.go.ke)
Go to SHA

What you need

  • The filled SHA claim form, the itemised invoice and the discharge or case summary (all three are mandatory)
  • The patient's verification reference and the pre-authorisation reference where needed
  • Clinical records: admission and discharge record, treatment sheet and medication chart, test requests and results, and operation notes if there was a procedure

Steps

  1. Verify the patient and get any pre-authorisation on the SHA provider portal before treatment.
  2. Submit the claim on the portal within 7 days of the service or discharge, whichever is later, with all documents attached.
  3. Check the Missing Documents tab under Invoices for sent-back claims, add what's missing and resubmit within 14 days.
  4. Track payments on the portal and in the payment reports SHA publishes on its Claim Payments page.

Watch out

  • If you skip a required pre-authorisation, SHA may reject the claim and you can't bill the patient instead.
  • For claim queries, email customerservice@sha.go.ke or call 147.

Who can apply

  • Hospitals, clinics and other providers that SHA has empanelled and contracted.
Official sources (6)
  1. Part B2 - Social Health Insurance Fund Contract (HCP contract 2026-2029) sha.go.ke · read 2 Oct 2026
  2. Notice to Healthcare Facilities/Providers - Update on Claims Status - Missing documents and Surveillance sha.go.ke · read 2 Oct 2026
  3. Part A - Master General Terms & Conditions (Part 1) sha.go.ke · read 2 Oct 2026
  4. SHA Forms sha.go.ke · read 2 Oct 2026
  5. Claim Payments sha.go.ke · read 2 Oct 2026
  6. SHA Provider Portal portal.sha.go.ke · read 2 Oct 2026

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