Operate, oversee, and understand healthcare insurance at national scale — scheme registry, enrollment, provider oversight, claims, payments, fraud detection, and analytics, in one connected platform.
Illustrative data from a demonstration environment
Every module visible in the dashboard above, available as a connected capability.
Maintain a single authoritative record of every healthcare insurance programme operating under your jurisdiction — formal sector, state schemes, vulnerable groups, and other categories.
Monitor beneficiary enrollment across every programme and HMO/TPA, with real-time visibility into growth, coverage gaps, and population reach.
Track accreditation status, network size, and performance across every accredited provider supervised by your authority.
Monitor pre-authorization volumes, turnaround times, and approval patterns across all supervised HMOs and TPAs.
Review claims volume, value, and status across the entire ecosystem — approved, pending, rejected — with drill-down to any HMO, TPA, or provider.
Track capitation and claims payments flowing through the ecosystem, with visibility into payment timeliness and outstanding obligations.
Surface exceptions — unlinked providers, high-utilizer patterns, accreditation gaps — before they become systemic risk.
State-by-state performance snapshots, programme-level breakdowns, and trend reporting to support policy and planning decisions.
A single platform serves every level of oversight — without requiring separate systems or manual reconciliation between them.
Policy and strategy oversight, national performance, resource allocation, regulatory control.
State programme oversight, provider monitoring, claims and payments, performance management.
Compliance monitoring, quality assurance, accreditation oversight, audit and enforcement.
Tamiin