Money & claims

SHA: eligibility, visits, preauthorisation and claims

Check SHA eligibility, get member consent, request preauthorisation, submit claims and record payment.

1Before you start

1
Facility connection
Your facility must be onboarded by SHA and your credentials entered under Integrations. AfeySync uses only the official SHA integration.
2
Emergency protocols
On the SHA page set up the emergency protocols and attending doctors your facility uses.

1
Search
Go to “SHA”, choose the identification type, enter the number and click “CHECK”.
2
Read the result
You see whether the member is eligible. Use “VIEW BENEFITS” and “VIEW UTILIZATION” for details.

1
Open the wizard
Click “Start SHA visit” on the patient, or go to “SHA Visits” → new.
2
Create the visit
Confirm the patient and click “Create SHA visit & continue to consent”.
3
Member consent
Get the member’s consent by OTP (“Send OTP”, then enter the code) or by SHA biometric verification, then “Verify & continue”.
4
Record services
Add the services given (“Add service”), each with its intervention, diagnosis and quantity.

1
Request
For services that need approval click “Request preauthorization”, add the clinical justification and estimated cost, then “Submit preauthorization”.
2
Follow up
Use “Refresh status” to see the decision. Respond to any questions from SHA with “Respond”.

1
Prepare
Go to “SHA Claims”. Open a draft, check the diagnosis codes and items, and use “Preview claim”.
2
Submit
Click “Submit to SHA”. For inpatients, discharging the patient sends the inpatient claim.
3
Status
Use “Refresh status”. If a claim needs correction click “Reopen for correction”, fix it and submit again.
4
Payment
When SHA pays, click “Record remittance” and enter the amount received. A claim is only marked paid when the money is received, never just because it was approved.

Need help with this? Our team can show you on a call.