SHA PROVIDER PORTAL USER GUIDE

FOR FACILITIES

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SHA PROVIDER PORTAL USER GUIDE
FOR FACILITIES
Facility Manual for Registration, Preauthorization and Claim Submission
1. A PATIENT WALKS INTO A FACILITY
Log in to the SHA portal
Step 1: Open your preferred web browser (e.g., Chrome, Firefox).
Step 2: Use your credentials to login at https://portal.sha.go.ke

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2. REGISTRATION: CHECK ELIGIBILITY ON THE CLAIM PORTAL https://portal.sha.go.ke
▪ If the member is active , proceed to start a visit in the claim portal. (See step 6)
▪ If the member is not available in the claim portal - do the following:
(i) Log into www.sha.go.ke and assist them to complete their registration
(ii) If the member is self employed, assist them to complete the means
testing and make payment.

3. LOG INTO THE CLAIM PORTAL AND START THE TREATMENT JOURNEY AT
https://portal.sha.go.ke
If the member is registered but not eligible - do the following;
▪ Ensure they have paid the premium
▪ If in self-employed complete the means testing and make the pay
▪ If in Employed category ask employer to declare them in the employer portal sha.go.ke

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TO ADD A CHILD OR SPOUSE AS DEPENDANTS - DO THE FOLLOWING:
Log in to www.sha.go.ke
▪ Go to profile
▪ Add dependants

DEVICES AND INFRASTRUCTURE

▪ Ensure ICT devices are available in the facility
▪ Confirm there is adequate network coverage
i) Contact 0800720601 for support
ii) ICT personnel to call 147
▪ Check power source
i) If there is no power use the power bank provided to charge the tablet

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4. HOW TO CHECK ELIGIBILITY IN THE PROVIDER PORTAL
Step 1: Click on the ‘Eligibility Tab’ on the left of the screen
Step 2: Select the appropriate search option, either via National ID or Phone
Step 3: Enter the member's national ID or phone number in the search box.
Step 4: Click on the “Look-up” member button or press enter to get your search results.
‘The name of the beneficiary, ID Number, their validity status and an action button to view will appear.’

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5. HOW TO START A VISIT
To begin a visit, select the interventions first which will appear on the “All selected interventions”.
▪ Then click on the "Start Visit" button as shown below:

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▪ Identify the patient using OTP as below

Patient A

Patient B

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▪ Identify the patient using OTP as below

NB: OTP (One Time Password): If you choose the OTP option, it will display the registered contact and
provide an option to confirm it. Once the number is confirmed, an OTP will be sent to the member's
phone number. The member will then read the OTP code to the assisting user, and the visit will be
initiated.

Payer Authorization. If the member does not have a phone, the facility can initiate authorization by
SHA through Pay Authorization capabilities. When you select this option you will be required to fill below:
▪ Current location
▪ Reason for payer authorization
▪ Attach supporting documents such as the ID, once the details have been filled, start the visit.
▪ Call 0800720601 for support in case of a challenge

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6. CHECK IF THE INTERVENTION “REQUIRES PRE-AUTHORIZATION”

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 • If it does not require Pre-Authorization proceed with treatment and submit a claim
• If it requires Pre-Authorization follow no 7.

7. HOW TO SUBMIT A REQUEST FOR PRE-AUTHORIZATION

There are interventions that require Pre-Authorisation before a visit is started. Every benefit has a Y or N
indicating whether Pre-Authorization is required or not. Please follow the below instructions to undertake
Pre-Authorization:
Step 1: Click on the claim
Step 2: Go to the Pre-Authorization Section as shown below
Step 3: Add the diagnosis and save

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Step 4: Add an amount
Step 5: Click Save
Step 6: Attach relevant documents (Pre-Authorization form, Clinical Summary and any
other supporting documents)

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Step 7: Click ‘select file to upload.’
Step 8: Click ‘submit preauth’ and wait for the approval.

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8. How to Submit Claim and discharge
When you want to submit a claim please do the following:
Step 1: Go to the claim page
Step 2: Input the invoice number as shown below and click SAVE
The Invoice Number is the number generated by your HMIS or invoicing system

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Step 3: Add the invoice lines that are on the invoice and select the appropriate Claim Intervention Bill Items
Step 4: Select the diagnosis by either adding by name, ICD 11 Code or Searching on website if the code is
unavailable Then click on SAVE

▪ The price is automatically pre filled as per the pricelist

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Step 5: Fill in the Item Name and Quantity then save
Step 6: Add invoice attachments. Invoice attachment include:
a. Scan of the invoice
b. Prescription
c. Scan of the claim form

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Step 7: On completion and uploading all the relevant documents, proceed to review and submit the
claim or discharge.
Step 8: Verify that the documents attached are correct, confirm then complete and submit the claim.

Contact 0800720601 for support

ICT personnel to call 147

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TO REGISTER, DIAL *147 #
OR VISIT
www.sha.go.ke