SHA directs Kenyans to verify hospital records amid fraud concerns
SHA Chief Executive Officer Mercy Mwangangi said patients should ensure their visits are accurately logged in the system on the day services are received.
The Social Health Authority (SHA) has called on Kenyans to be vigilant when accessing healthcare services under the national scheme, urging them to verify that every hospital visit is correctly recorded.
In a statement released on Thursday, SHA Chief Executive Officer Mercy Mwangangi said patients should ensure their visits are accurately logged in the system on the day services are received.
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Mwangangi explained that once a visit is entered into the SHA system, members will get a confirmation message on their registered phone.
“The message will contain details of the visit, which members are encouraged to review immediately to verify accuracy,” she said, highlighting the importance of prompt verification.
The authority said this process is essential to prevent fraudulent billing, duplicate entries, or incorrect charges that could compromise the scheme’s sustainability.
Patients have been advised to check their hospital bills before leaving the facility to make sure only the services received are charged and billed according to SHA rates.
The agency emphasised that members should not incur additional costs due to mistakes or delays by healthcare providers when logging visits or billing information.
For treatments requiring preauthorisation, SHA directed members to confirm approvals are in place before procedures, except in emergencies when immediate care is needed.
Any inconsistencies identified should be reported immediately either to the health facility or directly to SHA via the toll-free number 147.
Mwangangi stressed that these steps are part of broader efforts to increase transparency, curb abuse of the system, and ensure health funds are used efficiently.
The caution follows a major fraud investigation in the healthcare sector.
On September 1, 2025, the Directorate of Criminal Investigations (DCI) received 1,188 files from SHA and the Kenya Medical Practitioners and Dentists Council (KMPDC).
The files relate to individuals and institutions suspected of committing healthcare fraud and undermining government efforts to provide reliable and quality medical services to the public.
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