Multi-tenant enrollment
LiveBulk onboard employers, employees, and dependents. Assign plans, tier benefits, generate QR-linked digital ID cards.
For HMOs
Run every claim like it's already audited.
Preauths in minutes, adjudication at the line, denials with a code and a paper trail, and settlement inside the window the regulator actually set. Built for Nigerian HMOs, on the standards Nigerian HMOs answer to.
Capabilities
What HMO teams get on day one.
Live means shipped and in use inside the platform today. Roadmap items are named upfront so nothing on this page is aspirational.
Real-time preauthorization engine
Live1-hour NHIA SLA baked in. Auto-escalates emergencies. Service-window-aware auth codes issued per benefit line.
Encounter verification
Live6-step rule-based check (R41–R50) against eligibility, plan coverage, and medical necessity — before a claim ever exists.
Per-line claims adjudication
LiveApprove, deny, or adjust every claim line. Snapshotted ICD codes, benefit codes, and NHIA tariffs on each decision.
Configurable denial catalogues
Live7 NHIA-aligned denial categories with per-org denial and adjustment codes. Soft-deactivate without losing history.
Denial + AR analytics
LiveDenial rate by category, provider, and time. AR aging reports. Clean-claim tracking. All computed at query time.
Claim appeals workflow
RoadmapVersioned re-adjudication that honours the NHIA 30-day appeal window without overwriting the original decision.
Batch settlement + remittance advice
RoadmapGenerate remittance PDFs, reconcile payments, and track the 60-day settlement clock across cohorts of claims.
Regulator-facing exports
RoadmapNHIA-format denial category exports and compliance reports, ready to hand over on request.
Compliance by design
Built to the NHIA spec, not adapted for it.
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
See it in a 20-minute demo
Ready to see what a claims platform built for Nigeria actually looks like?
Book a walkthrough for your HMO, hospital, or employer scheme. We'll show you the real product, on real data structures, in twenty minutes.