the claim is marked before the payer sees it
Nairobi Hack Day · 17 August 2026 · health
Owed to county health facilities by SHA
KSh 26.87bn
as of 31 March 2026
Claims rejected, returned, or awaiting documents
1 in 5
by value
Some faith-based hospitals draw 90% of income from SHA. Facilities have gone five months without payment.
Failure one
Discovered weeks later, when the patient is gone and the record can no longer be repaired.
Failure two
a system that rejects claims without explanation, provides no mechanism for dispute resolution, and leaves facilities trapped in an information black hole
hospital administrators, as reported
What changes
12 conditions, run while the patient is still in the building. The only moment a missing pre-authorisation is a correction rather than an appeal.
One claim, marked
Three pens, not a colour ramp
The half nobody builds
LAB-BASIC is separately payable alongside OP-GEN and does not appear on the claim. KES 600.00 the facility is entitled to and did not ask for.
KES 8,520.00 never asked for, across 8 claims
Not upcoding. The intervention is in the notes. A tool that only ever costs a clinician time gets switched off.
At submission
12 conditions, the ones satisfied, the ones raised, and a timestamp. This is the part that matters months later.
The letter the hospital could not previously write
APPEAL: UNEXPLAINED NON-PAYMENT Facility Kariobangi Sub-County Hospital Claim KSH-26-08-0418 Member Grace Achieng (SHA-1194320) Package SURG-MIN Encounter 2026-08-09 Amount claimed KES 15,000.00 Submitted 2026-08-17T09:20:00 Outcome rejected Reason returned NONE. No reason code was provided PRE-SUBMISSION VERIFICATION At submission this claim was checked against 12 conditions and satisfied 12 of them: SHA-MEM-01, SHA-LVL-01, SHA-CON-01, SHA-PRE-01, SHA-DOC-01, SHA-DX-01, SHA-DUP-01, SHA-WIN-01, SHA-REG-01, SHA-TAR-01, SHA-UND-01, SHA-UND-02 No condition was raised. The claim was complete on submission.
GROUNDS
This claim satisfied every condition verified above on the date of submission,
and no reason code accompanied the non-payment. Absent a stated ground, the
facility cannot correct, cannot resubmit, and cannot concede.
REQUESTED
1. The reason code and the rule relied upon for this specific claim.
2. If the ground is a missing document, its name; the attachments at
submission were: invoice, theatre_notes.
3. Failing a stated ground within the appeal window, settlement of KES 15,000.00.
Attached: the submission snapshot and the verification record, both timestamped
2026-08-17T09:20:00.
It grades itself
A warning the payer then paid in full. Counted and published, because a compliance tool that hides its own false-alarm rate is asking a hospital to take its word for it. Four settled claims, so this is wiring shown working, not a performance claim.
Said plainly
So every tariff, document list and window declares its own grounding, and it renders on the mark:
The engine is the contribution, not the numbers.
the claim is marked before the payer sees it
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