Church hospitals say unpaid NHIF claims crippling them



Church hospitals say unpaid NHIF claims crippling them

National Health Insurance Fund
National Health Insurance Fund (NHIF) offices in Nairobi. FILE PHOTO | NMG 

Faith-based churches, which provide 40 percent of health services in Kenya, are protesting delay of billions of shillings owed to them by the National Health Insurance Fund (NHIF), due to a system change.

Hospitals linked to the Catholic Church say NHIF owes more than Sh1.3 billion with the unpaid claims going back to 2017.

The hospitals also complain about the lengthy process that NHIF takes to accredit their centres.

Similar complaints and mounting unpaid claims have been registered by hospitals under the protestant umbrella Christian Health Association of Kenya (CHAK).

Dr Samuel Mwenda Rukungu, the General-Secretary of CHAK, under which hospitals like Kijabe, Tenwek and Tumutumu fall, said that the facilities had been working well with NHIF “until sometimes last year when the claims have been posing a challenge”

Ms Jecinta Mutegi, National Executive Secretary for the Catholic Health Commission of Kenya said that their referral facilities — of level four and above — were most affected.

“Suppliers have refused to give us commodities anymore, we are unable to pay salaries,” Ms Mutegi told the Business Daily.

She said Mater Hospital is owed Sh350million, Our Lady of Lords Hospital in Mwea (Sh120m) and Consolata Hospital Mathari in Nyeri Sh110 million while North Kinangop Catholic claims amount to Sh81m.

An electronic system of lodging claims was adopted following scandals that rocked the national insurer, but is appears the measure meant to tame runaway corruption has complicated the claims process.

The system, a hospital director in Nyeri said, fails to capture the claims when they are keyed in.

Another hospital director said that they have to travel to the branches to feed the details, and when they call the NHIF officials to come to the hospitals to verify some of the major surgery claims as is the standard procedure, the officials ask for vehicles to transport them to the facilities.

The hospital administrators said that after complaining a lot, NHIF gives them hush money — as little as Sh10million — and the push and pull starts again

“NHIF has credit contracts with individual hospitals and we pay them on a regular basis. We need to confirm the status since each hospital has a separate contract for the credit work they do with NHIF,” said NHIF in a statement on Tuesday.


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