The operating system for HMOs, providers, and enrollees in Nigeria — from enrollment to settlement, one audit trail. Built to the NHIA spec, not adapted for it.
Sonecare · Member
Amaka Onyeka
Plan · Gold · Family
Abdominal ultrasound
CityCare Medical · Ikoyi
Claim · CL-9032 · Line 3
₦48,200
Purpose-built for Nigerian healthcare · Standards we speak natively
Every enrollee visit, every preauth code, every settled line — one graph. No spreadsheets, no lost referrals, no month-long adjudication cycles.
A single claim moves through Sonecare in a straight line — every state change captured, timestamped, and joinable back to the enrollee, the provider, and the tariff version that was live when the decision was made.
Encounter created
NowCityCare Medical · Amaka Onyeka
Preauth requested
Abdominal ultrasound · Line 1
Preauth approved · 4m 12s
Auth code PA-4821 issued
Claim submitted
3 lines · ₦134,500 billed
Adjudicated
3 lines approved · ₦128,900
Settled · day 22
Well inside 60-day window
Every rule that matters lives inside the model, not in a compliance memo. The platform is the audit trail.
1-hour preauth SLA
Auto-escalated for emergencies
60-day settlement
AR aging tracked to the day
HCFA 12-diagnosis claims
Sequence-aware, standards-compliant
Immutable tariff snapshots
Decisions frozen against the version live at claim time
Per-org denial catalogues
7 NHIA-aligned categories, fully configurable
Regulator-ready exports
Audit trail regulators can actually consume
The stuff that makes claims defensible in an audit and payable inside 60 days — modelled, indexed, and shipped.
Adjudicate at the line
Snapshotted ICD codes, benefit codes, and NHIA tariffs on every decision. Nothing gets rewritten silently.
Analytics
Denial rate by provider, category, and time. Spot patterns before they become disputes.
Data model
HMOs, providers, employers, and regulators query the same platform. Data isolation is automatic.
Enrollees
QR-linked to live coverage. Instantly checkable at any in-network facility.
Sonecare · Member
Amaka Onyeka
Cashflow
See what's outstanding, when it ages out, and which claims are blocking settlement.
Built to last
SELECT FOR UPDATE counters prevent collisions under load. Every mutation is logged.
with transaction.atomic(): claim = Claim.objects.select_for_update() claim.number = next_atomic(org) claim.save()
One interface for claims teams, medical officers, and finance — with per-faction views baked into the platform, not bolted on.
Today · HMO Operations
Preauths / hr
42
+8% vs last wk
Adjudicated
₦2.1m
+12% vs last wk
Denial rate
6.4%
−1.2% vs last wk
Avg. settle
38d
−4d vs last wk
Illustrative view — real dashboard varies by faction (HMO · Provider · Client · Regulator).
Why we're building this
Denied claims that resurface weeks later. Providers waiting past 60 days for money already earned. Preauth requests that get lost in email threads. Enrollees turned away at facilities because eligibility can't be verified in real time. This is what “the claims lifecycle” looks like across most of the country, and it's not because the people running it are careless — it's because the tools they've been handed pretend the whole thing fits in a spreadsheet.
Sonecare is a bet that if you model this domain properly — every faction, every rule, every version of every tariff — the friction that's been treated as inevitable actually disappears. Preauths issue in minutes. Claims adjudicate line-by-line. Denials come with a code and a paper trail. Settlements happen inside the window the regulator set.
One platform. One graph. One audit trail — from the first enrollee onboarded to the last naira settled.
≤ 1 hr
Preauth SLA
NHIA-aligned, emergency-aware
60 days
Settlement window
AR aging tracked to the day
6 steps
Verification per encounter
R41–R50 rule set
4 factions
One platform
HMO · Provider · Client · Regulator
Design targets baked into the platform — not marketing traction.
See it in a 20-minute demo
Book a walkthrough for your HMO, hospital, or employer scheme. We'll show you the real product, on real data structures, in twenty minutes.
