Admit and discharge patients using the HIC system that will remain operational and operate in parallel
– Elijah Wachira, SHA Acting CEO
By Rose Mukonyo
The Social Health Authority has directed all healthcare providers to continue attending to patients using the HIC (Hospital Insurance Claims) system as the authority implements the new provider portal that will verify and process claims.
Through a statement, SHA Acting Chief Executive Officer (CEO) Elijah Wachira has directed the healthcare providers to admit and discharge patients in their facilities using the HIC system that will remain operational and operate in parallel.
“Please ensure that patients suffering from chronic or critical illnesses continue to access healthcare services without interruption during this transition period,” reads part of the statement.
Wachira noted the move is to ensure patient care continues seamlessly while hospital staff undergo training and enrollment in the new system.
The directive comes barely hours after another statement by the Renal Association of Kenya noting that using the old NHIF claim system poses a financial risk to providers dealing with the defunct entity.
According to the Kenya Renal Association Chairman Dr Jonathan Wala, the directive to use a manual claims process lacks legal and regulatory support leaving providers vulnerable to unpaid claims.
One of their greatest concerns is the Ksh10 billion owed by NHIF to the dialysis service providers with no formal mechanism to address it.
The association is, therefore, recommending that formal contracts between SHA and dialysis service providers be established and executed to provide legal assurance to all parties involved, including the patients.
“At the Kenya Renal Association, we firmly believe that the lives of our patients are paramount. The current disarray in a health insurance scheme of such critical importance is unacceptable. We urge the SHA and all stakeholders to act swiftly to prevent further jeopardy to the lives of vulnerable kidney patients across Kenya,” reads part of the statement.
Earlier this week, when the SHA was officially launched, several dialysis patients were stranded after receiving a text message from their service providers to pay out-of-pocket for their dialysis sessions, one that was changed, and they were allowed to undergo their dialysis.
This has caused panic among many patients who have not been registered in SHA and have been required to pay in cash.
The Kenya Renal Association is, therefore, urging the government to provide clear, consistent guidelines for both patients and dialysis service providers anchored on the Social Health Insurance Act, to ensure uninterrupted and reliable service delivery.
