The Government through the Ministry of Health, plans to spend at least KSH. 5B in building a single digital platform which will be used in lodging, validating and paying medical insurance claims under the Social Health plan.
The platform, a Centralized Healthcare Provider Management System (CHPMS), will manage claims and cut fraud. It will be used by hospitals to lodge claims after treating patients.
Further, it will review claims, validate them and process payments under the Government’s ambitious healthcare plan that will be funded by Kenyans to a tune of KSH. 133B a year through a deduction of 2.75% of their monthly income.
CHPMS will permit user rights to authorized persons and apply to the board for rights and access to the system in line with the Data Protection Act 2019 and the Digital Health Act, 2023.
The Ministry of Health estimates the installation of the system will cut losses linked to fraud to between 10 – 20% of the total claims paid out.
