Phase 1 · Product 03
SchemeIQ.
AI for medical schemes.
73 registered schemes. R260bn in annual claims. 42% of member calls are about benefit confusion. SchemeIQ is the AI operations platform built specifically for South African medical aid scheme operations — reducing call centre volume by 35–50% while improving member satisfaction.
Three agents · one platform
Cut volume. Retain members. Automate the routine.
01 · agent
member-ai-agent
Answers benefit queries via WhatsApp in plain language, in seconds — available in all 11 SA official languages.
02 · agent
pre-auth-agent
Triages pre-auth requests, resolves routine approvals automatically, escalates complex cases to clinical staff.
03 · agent
retention-agent
Predicts member lapse before it happens and intervenes with personalised, automated outreach.
Call centre reduction
35–50%
Integrations
Rx20 · Rx30 · Proprietary systems
Languages
All 11 SA official languages
Compliance
POPIA · CMS · ZA residency