Verified at source
Nothing enters the chain unverified. Identity is proved biometrically, entitlement is resolved live, and the encounter is stamped before anything clinical or financial happens.
SeptiBytes Solutions builds data platforms for organisations that carry real risk. MedicalBytes is our health insurance risk management product.
SeptiBytes Solutions builds data platforms for organisations that carry real risk. MedicalBytes is our health insurance risk management product: the linear feature chain that administers a health benefit pool from the moment a policy is signed to the moment a provider is paid.
We work with third party administrators, medical schemes and insurers, hospital groups, pharmacy networks, clinics and day facilities.
Capture data once, at source, verified. Validate it against rules held in one place. Then let every later decision be made automatically from that trusted data, escalating to human judgement only where judgement genuinely adds value.
Nothing enters the chain unverified. Identity is proved biometrically, entitlement is resolved live, and the encounter is stamped before anything clinical or financial happens.
Benefit structures, sub-limits, tariff sets, provider tiers, approval ceilings and roles are configured per client and effective-dated, so history is always judged by the rules that were in force at the time.
Every decision traces back to the rule, the version and the user that produced it. That is what makes the platform examinable by internal audit, external audit and the regulator.
Implementation is a five-stage programme with a parallel run before anything is switched off, and a rollback plan at cutover. Nobody is asked to trust the new engine until it has agreed with the old one.
Give us a set of real claims and we will run them through the engine line by line: identity, entitlement, authorisation, coding, adjudication and settlement.
Tell us what you want to see and we will reply within one business day.