Vetra

A claims management platform that unifies claims, provider settlements, and analytics for health insurance operations. It solves the problem of fragmented workflows by providing a single system of record with AI fraud detection and risk scoring. The platform is sold to HMOs, provider networks, employer benefits teams, finance teams, and leadership in the Nigerian healthcare market. It is delivered as a cloud-based SaaS platform with role-specific portals and enterprise-grade security.

Key features

• AI fraud detection and risk scoring
• Duplicate claim detection
• Tariff intelligence and benefit limit checks
• Next-action guidance for reviewers
• Eligibility verification before care
• Rules-led authorization workflow
• Claims adjudication with clinical context
• Batch settlement runs with reconciliation
• Multi-level approval matrix
• Provider remittances and dispute resolution
• Real-time analytics dashboards
• Loss ratio and utilization tracking
• Role-based access control
• Encryption in transit and at rest
• Audit trails for sensitive actions