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SHA dialysis claims in Kenya: what the record needs to prove
For a dialysis facility, SHA claim readiness starts before the session. The clinical record, bill and supporting evidence need to show what was authorised, delivered, reviewed and followed up.
The short answer
A dialysis claim is easier to prepare when the facility can trace one treatment session from patient identity and coverage checks through prescription, chair attendance, intradialytic observations, medicines, consumables, doctor review, itemised billing and follow-up status.
Nanto Health treats this as claim readiness. It helps the facility prepare, validate and track the record. SHA makes the final decision on every claim.
Start with the official benefit boundary
Kenya's public tariff materials include a renal care services package covering haemodialysis, haemodiafiltration, peritoneal dialysis and renal replacement therapy items, with access rules and tariffs set outside the facility system. Facilities should confirm current package details against the official legal and SHA sources before using any tariff operationally. Review the current tariff notice on Kenya Law.
What the record should connect
- Patient and coverage: the patient identity, facility record and coverage status used for the episode.
- Authorisation trail: preauthorisation, referral or course details where required by the facility workflow.
- Clinical session: prescription, access, chair, machine values, vitals, medicines, consumables, complications and interventions.
- Review: the clinical sign-off, correction history and any documents the facility attaches to the episode.
- Bill and follow-up: itemised charges, claim status, return reasons, resubmission actions and payment reconciliation.
Why a generic HMIS often struggles here
Dialysis is not a short outpatient note. A four-hour session creates timed observations, consumable use, nursing work, doctor review and billing evidence. If those details sit in separate forms, paper files and spreadsheets, the claims team may have to rebuild the session later.
A renal unit should test whether its software has a real dialysis-session object, not only a general consultation screen with free-text fields.
DHA and interoperability questions to ask
The Digital Health Agency describes a national certification programme for digital health systems and lists EMR and HIS categories. Nanto Health does not currently claim DHA certification. A facility buyer should ask every vendor which certification, onboarding, credentials and integrations are active today and which are future roadmap items. Read the DHA system categories, or see our guide to DHA certification in Kenya for how a system is scored and how to verify a vendor claim. The SHA claim-readiness workflow and the dialysis EMR describe what Nanto Health does today.
Where Nanto Health fits
Nanto Health is built for the renal workflow first. It keeps the treatment-floor record, claim-readiness checks and status follow-up on one visible trail, while keeping direct electronic submission behind the required onboarding, testing, certification and production credentials.