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Commercials

What it costs, and how you go live

The TPA (Full) package, every feature, licensed per member per year, with the rate stepping down as the book grows, plus a once-off $20 setup fee per profile opened. Implementation is scoped after discovery and integration is priced per interface.

  • $40 / member / year · 0-5 000 members
  • $35 · 5 000-15 000 · $30 · 15 000-30 000
  • 30 000+ members · negotiated for the book
Commercials · TPA (Full) package

Priced per member, per year

One package: every feature, end to end. The rate steps down as the book grows, and there is a once-off setup fee of $20 for every profile opened.

0-5 000 members
$40per member, per year

+ $20 once-off setup fee per profile opened

  • Every feature, end to end
  • Biometric verification at the point of service
  • Provider, pharmacy, HR and member portals
  • Dashboards per scheme, client and provider
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5 000-15 000 members
$35per member, per year

+ $20 once-off setup fee per profile opened

  • Everything in the tier before it
  • The lower rate applies across the whole book
  • Parallel run and staged cutover included
  • Support window with a defined response time
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15 000-30 000 members
$30per member, per year

+ $20 once-off setup fee per profile opened

  • Everything in the tiers before it
  • Multi-client, multi-scheme separation
  • Named implementation and hypercare team
  • Integration programme scoped per interface
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30 000+ members
Contact usnegotiated for the book

Setup fee agreed as part of the engagement

  • Everything in the tiers before it
  • Multi-country and multi-entity books
  • Data residency and tenancy options
  • Enterprise support agreement
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Licence

Per member, per year: $40, $35 or $30, set by the number of members under administration across the book.

Setup

A once-off $20 for every profile opened, charged as members are enrolled rather than as an upfront lump sum on the whole book.

Implementation & integration

Scoped after discovery so the number reflects your rulebook, priced per interface, then a support window with a defined response time.

All figures in USD. Tier boundaries are assessed on members under administration across the book.

Implementation

How we get you live

Five stages, with a parallel period 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.

01

Discovery

Your rulebook, plans, tariffs, providers and current systems mapped.

02

Configure

Benefits, sub-limits, rules and roles loaded. Your rulebook, not a template.

03

Integrate

Membership, provider, finance and clinical interfaces built and tested.

04

Parallel run

Live claims processed in both systems and reconciled before you switch.

05

Cutover

Staged, with a rollback plan, then training and hypercare support.

Frequently asked

The questions that come up first

If your question is not here, ask it directly. We would rather answer it before a proposal than after one.

Do we have to replace our current administration system to start?
No. Implementation runs through a parallel period: live claims are processed in both systems and reconciled before anything is switched off. Cutover is staged, with a documented rollback plan, and integration is built per interface (membership, provider, finance and clinical systems) rather than as one big-bang migration.
Is the platform configured to our rules, or do we adopt yours?
Yours. Benefit structures, sub-limits, co-payment logic, tariff sets, provider tiers, approval ceilings and roles are all loaded per client during configuration. Plans and tariffs are effective-dated, so historic claims are always evaluated against the rules that were in force on the date of service, not the rules you use today.
What happens at a facility with unreliable connectivity?
Biometric verification is designed to work offline: the match runs locally against the stored template, the encounter is recorded, and it synchronises when the connection returns. Where a member genuinely cannot be captured (a failure-to-enrol or failure-to-capture case), there is a defined exception protocol with named override authority, mandatory reason codes and a full audit trail.
How are biometric and clinical data protected?
Biometrics are stored as encrypted mathematical templates, never as raw fingerprint or facial images, and consent is captured at enrolment. Access to diagnosis and personal identifiers is masked from users without a clinical or legal need to know, controlled by role-based access control, and every access is logged. Data handling is aligned to POPIA and to the data residency requirements of the jurisdictions you operate in.
Can providers submit invoices the way they already do?
Yes. Intake is deliberately omni-channel: direct system-to-system integration, the provider portal, bulk file upload, an email inbox, mobile capture and scanned paper batches. The invoice reception engine reads all of them, and low-confidence documents route to a validation queue instead of being rejected back to the provider.
How is the platform licensed?
Licence is charged per member per year on the TPA (Full) package, which includes every feature: $40 per member for 0-5 000 members, $35 for 5 000-15 000, and $30 for 15 000-30 000. Above 30 000 members it is negotiated for the book. There is a once-off setup fee of $20 for every profile opened, charged as members are enrolled. Implementation is a once-off scoped after discovery, and integration is priced per interface, followed by a monthly support window with a defined response time. All figures in USD.
Who can see what?
Permissions attach to roles, and roles are scoped by client, scheme, provider network, geography and branch. Segregation of duties is enforced by the platform: the maker of a transaction cannot be its checker or its payer. Approval authority carries monetary ceilings per role and per user. Every permission change is logged with before and after values.
Walk your own claims

Bring a sample. We will show you the chain.

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.

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