The Social Health Authority (SHA) has introduced new documentation requirements for healthcare providers submitting medical claims involving children living under alternative care arrangements.
In a public notice issued on Thursday, July 16, SHA Chief Executive Officer Mercy Mwangangi said the authority had identified inconsistencies in the documents submitted to support claims for children under alternative care, prompting the introduction of standardized requirements to improve claims processing.
Under the new guidelines, healthcare providers treating adopted children will be required to submit a certified adoption order when filing claims.
The Social Health Authority (SHA) headquarters. Photo: Courtesy.
For children under legal guardianship, providers must submit either a deed or will appointing the guardian or a certified court order confirming the guardianship arrangement.
Claims involving children under kinship care must be accompanied by either a court-issued custody order or a letter from a children’s officer confirming the kinship care arrangement.
Healthcare providers handling claims for children in foster care will be required to submit a foster care placement approval issued by the Secretary of Children’s Services or a relevant court order.
For children living in charitable children’s institutions, facilities must provide both a court committal or care order and the child’s admission record from the institution.
Children placed under the care of relatives through court orders will require a certified copy of the court order, while claims involving parental responsibility arrangements must be supported by the relevant legal instrument establishing that responsibility.
Additionally, SHA said claims for children under the Kafaalah care arrangement must be accompanied by either a certificate of registration or a placement certificate.
The authority said the new requirements are intended to standardize documentation across all categories of alternative care, ensuring consistency and smoother processing of medical claims submitted by contracted healthcare providers.
