Solutions · Medical Schemes
AI automation for South African schemes.
Three solutions that cut call centre volume, automate claims processing, and retain more members — without adding headcount.
Member AI & Benefit Navigation →
Give every member instant, accurate benefit answers via WhatsApp — in plain language, in seconds, without calling your call centre. Available in all 11 SA official languages.
- WhatsApp
- 11 Languages
- Benefit Queries
- 24/7 Availability
Claims & Pre-Auth Automation →
Automate pre-auth triage, resolve routine claims exceptions without human review, and cut processing backlogs. Built for SA schemes running on Rx20, Rx30, or proprietary systems.
- Pre-Auth Triage
- Claims Exceptions
- Rx20
- Rx30
Gap Cover & Retention Intelligence →
Automate gap claim submission, predict member lapse before it happens, and intervene with personalised outreach. Turn retention from reactive to proactive.
- Gap Claims
- Lapse Prediction
- Member Retention
- AI Outreach