SHA Warns on Fake Bills
The Social Health Authority (SHA) is reminding Kenyans to double-check their hospital bills and visit details each time they seek healthcare services at facilities that are part of the scheme.
In a public notice released on Thursday, October 9, SHA CEO Mercy Mwangangi encouraged everyone to make sure their hospital visits are correctly logged in the SHA system.
“The Social Health Authority (SHA) urges all members to carefully review their hospital bills and visit details each time they receive healthcare services at a SHA-contracted Healthcare facility,” read the statement in part.
Mwangangi pointed out that after a visit is scheduled in the SHA system, patients will get a confirmation message sent to their phone numbers. The SHA CEO emphasized that it’s important for the public to double-check the details in the message to ensure everything is correct before they leave the medical facilities.
“You will receive a confirmation message on your SHA-registered phone number once your visit has been started in the system. Kindly review the details in the message to confirm accuracy,” she stated.
Mwangangi explained that this initiative is designed to prevent members from facing any extra costs due to delays or mistakes in visit entries or billing.
She also emphasized that for any procedures that need preauthorization, it’s crucial for Kenyans to secure that approval in advance, unless it’s an emergency situation.
This announcement follows the recent handover of 1,188 files related to healthcare fraud from the SHA and the Kenya Medical Practitioners and Dentists Council (KMPDC) to the Directorate of Criminal Investigations (DCI) for further investigation.
The KMPDC has indicated that the fraudulent schemes being looked into include inflating medical bills by misclassifying outpatient visits as inpatient admissions, falsifying medical records, billing for procedures that were never performed, and submitting claims for patients who don’t actually exist.
“This action targets fraudulent and non-compliant healthcare facilities and individuals, marking a critical milestone in the ongoing effort to protect public funds and safeguard the integrity of Kenya’s healthcare system,” Health CS Aden Duale stated.
On August 26, SHA made the decision to suspend 45 health facilities from offering services under the Social Health Insurance program.
The facilities that have been suspended cover several counties, including Mandera, Kisii, Kisumu, Turkana, Kakamega, Homa Bay, Meru, Migori, and Kirinyaga
SHA Warns on Fake Bills
