The Social Health Authority has collected Sh20.9 billion since its launch in October last year, the Ministry of Health has said.
It said the authority has subsequently processed claims from both public and private hospitals.
“The claims are categorised into paid Sh18.2 billion, out of which Sh16.97 billion relates to SHIF claims and Sh1.33 billion to Primary Health Care capitation,” it noted.
The ministry said the disbursement of Sh18.2 billion underscores the government’s strong commitment to ensuring that healthcare providers receive timely reimbursements for services rendered.
“By facilitating payments across both public and private health facilities, the government is safeguarding uninterrupted healthcare access for all Kenyans, reinforcing its dedication to achieving Universal Health Coverage (UHC) under Taifa Care,” the ministry said.
The minimum contribution for the most vulnerable households to Social Health Insurance Fund (SHIF) is set at Sh300, a reduction from the Sh500 charged under the National Health Insurance Fund (NHIF).
However, contributions vary among households, just as they do in the formal sector, ensuring that those with higher incomes contribute proportionally more.
This approach prevents low-income Kenyans from being locked out of the healthcare system due to financial constraints while maintaining equity in funding.
In a statement sent to newsrooms on Wednesday, the ministry said the government is committed to transparency and accountability in the disbursement of SHIF payments to healthcare providers across the country.
The ministry added that SHA has prioritised faster claim processing through digital platforms to enhance efficiency. It said the platforms enable real-time tracking of claims.
It noted that despite the law prescribing a 90-day credit period for claim settlement, SHA has consistently processed and disbursed payments in under 30 days.
“This accelerated turnaround reflects the government's proactive approach to strengthening healthcare financing, reducing the financial strain on facilities, and improving the overall responsiveness of the health system," the ministry said.
It added that some claims remain pending due to incomplete documentation, ongoing verification processes, or preauthorisation challenges.
To resolve this, the ministry said it is working closely with healthcare facilities to accelerate claim processing, ensuring that all valid payments are settled promptly.
“Hospitals facing delays are encouraged to engage with SHA
for assistance in addressing submission issues and improving claim accuracy,” the ministry said.
To enhance transparency and accountability, the ministry said all claims are undergoing a clinical audit to confirm that preauthorised procedures were properly approved and performed before payments are processed.
“This rigorous verification ensures that healthcare funds are disbursed appropriately, preventing fraud and improving financial integrity within the sector," the ministry stated.
