Returned SHA claim? Get a fix-list within 24 hours.
Send the returned claim on WhatsApp with patient names and ID numbers covered. Our AI drafts a check against SHA's documentation rules, and a registered health records officer reviews it and tells you exactly what to fix or upload, before the 14-day window for missing documents runs out.
Free for the first 15 facilities during the November 2026 pilot.
How it works
Cover patient details
Hide names, and all but the last 3 digits of ID and SHA numbers. A strip of paper before the photo is enough.
Send it on WhatsApp
Photos or PDFs of the claim form, invoice, discharge summary and anything SHA asked for, plus the status SHA shows.
Get your fix-list
Within 24 hours: what to fix, what to upload and by when. A registered health records officer reviews every line before it reaches you.
What we check
Documents
- Discharge summary, signed and dated
- Invoice and final bill, matching the claim
- Claim form signatures and stamp
- Preauthorization, where the service needs one
- Lab and imaging results for every billed line
- Referral letter, birth notification or death certificate when they apply
Consistency
- Admission and discharge dates across every page
- The same diagnosis on the claim, summary and results
- Clinician name, registration number and signature
- Line amounts that do not exceed the original
- Deadlines: 24 hours for emergencies, 14 days for missing documents
What we never do
- Ask for your SHA portal login. Your team submits; we only review.
- Create, change or back-date a clinical record, or suggest adding care that was not given.
- Contact your patients.
- Keep your claim files after the pilot. They are deleted within 30 days of it ending.
Who the pilot is for
Private and faith-based Level 3 and 4 facilities in Nairobi and Kiambu that submit SHA claims every month, especially inpatient, maternity and surgical claims.
ClaimSafi is an independent service by Claimsafi Ltd (in formation). It is not part of, or endorsed by, the Social Health Authority.
Questions
Do you replace our claims officer?
No. We give your claims officer a second check before resubmitting, so fewer claims come back twice.
What does it cost?
Nothing during the November pilot. If the fix-lists are worth it to you, we will agree a monthly price before December.
How fast is it?
Within 24 hours of receiving a complete set of photos, Monday to Saturday.
Can you guarantee SHA will pay?
No. SHA decides every claim. We find documentation gaps before SHA does, so your team can close them.
Privacy
We collect your facility's name, contact person and phone number, and the claim documents you send with patient details covered. We use them only to prepare fix-lists and run the pilot.
Claim photos are read by Anthropic's Claude AI service, outside Kenya, under business terms that do not use them to train AI. A registered health records officer reviews and signs every fix-list before it is sent to you.
Claim files stay on an encrypted computer and are deleted within 30 days of the pilot ending. Facility contact details and fix-list notes are kept in a database run by our provider, Supabase. Booking-form answers are collected by Tally, which is hosted in the EU, and copied to our Google Sheet. These providers may store data outside Kenya.
To see, correct or delete your data, write to hello@claimsafi.co.ke.