TPA Infrastructure for Cross-Border Healthcare
Claim management, network access, cost containment, and regulatory-grade reporting for insurers operating across Africa — active today in Libya and Mauritania.
What We Offer Insurers
Claim Management
End-to-end claim intake, review, adjudication, and settlement.
Network Access
A vetted domestic network across Libya plus curated hospital and specialist relationships abroad, led by Turkey and Egypt.
Cost Containment
Pre-negotiated tariffs, pre-authorisation review, and audit services.
Reporting Dashboards
Monthly analytics on claims, costs, and provider performance.
Structured Documentation
Structured documentation can support internal review, authorisation, and audit workflows.
API Integration
Data exchange and system integration — available in V2.
Technical Capabilities
Operational Capabilities
- Pre-authorisation management within agreed service timelines
- Claim adjudication and audit
- Provider tariff negotiation
- Cost containment and fraud detection — reducing claims costs by up to 60%
- Case management for complex claims
Compliance & Reporting
- Structured monthly reporting package
- Audit trail for all authorisations and claims
- Documentation structured for institutional review and internal audit workflows
- Secure data handling protocols
- On-request case reporting and documentation support
Our Partnership Model
RFP & Discovery
We receive your requirements and propose a tailored TPA structure.
Pilot Phase
A supervised 90-day pilot with daily reporting and close coordination.
Full Scale
Live operation with monthly performance and cost reviews.
Explore a TPA Partnership
Contact our partnerships team to discuss a custom TPA arrangement.