SHA replaced NHIF — what changed for your billing
Kenya replaced NHIF with the Social Health Authority in late 2024. The claim formats changed, the bands changed, and your software has to change with them.
The Social Health Authority replaced the National Hospital Insurance Fund in late 2024 as part of the Universal Health Coverage rollout. If you bill insurance in your business — pharmacy dispensing, clinic visits, hospital out-patient — the practical changes affect your day-to-day workflow.
The rate bands changed. The old NHIF flat-rate-by-salary system is gone. SHA uses a tiered contribution that scales with declared income. Employers calculate and remit per the new schedule.
The claim format changed. SHA introduced a new XML format with additional fields (ICD-10 diagnosis code, procedure code per service, prescriber HCP number). Old NHIF claim files no longer submit cleanly.
The provider numbering changed. Existing NHIF provider codes were migrated to new SHA codes — most were preserved with a prefix change, but some facilities got new numbers entirely.
What Omnix updated automatically (in v0.1.6, February 2026): - New rate band table for SHA contributions - New XML claim format - Mapped your old NHIF provider code to the new SHA code (one-time auto-migration on first launch) - Added ICD-10 selector to dispensing module so the diagnosis code populates the claim - Updated the payroll deduction line to read "SHA" not "NHIF"
What you still have to do: - Verify your facility's SHA code matches the migration. Most do; check via the SHA web portal once. - Train your dispensing staff to enter the diagnosis code when claiming insurance. The first few weeks will be slower; it becomes automatic. - Re-register any private insurance schemes that piggy-backed on NHIF (AAR, Jubilee, Britam, Madison) — most have their own SHA-aligned forms now.
Tip: Keep the patient's old NHIF number on file even after migrating. Some bigger employers still reference it in HR records and claims data.
If you're moving from a competitor's software that hasn't updated for SHA, you have a problem in the order of weeks not months — claims will start failing.