Run your HMO on Vetra.

1. 1

   Activate your workspace

   Your tenant URL is app.vetrainsure.com/<your-tenant>. The initial admin invite arrives by email.
2. 2

   Configure roles

   Settings → Roles. The platform seeds Admin, Claims Manager, Adjudicator, Finance, Provider Relations and Read-only. Customise from the 55+ permission catalog.
3. 3

   Set approval limits

   Settings → Approval Limits — who can sign off on claims and settlement runs above given thresholds.
4. 4

   Onboard plans

   Create plan tiers, benefit limits and exclusions under Plans. Powers eligibility, PA auto-approval rules and the enrollee portal coverage view.
5. 5

   Onboard clients & enrollees

   Add corporate clients and bulk-import enrollees. Vetra issues a Member ID per person (HMO-CLIENT-NNNNN-TYPE).
6. 6

   Link providers

   Search the Network directory and send "link to network" requests. Linked providers can submit claims and PA requests directly.
7. 7

   Invite staff

   Roles & Users → Invite. Each invitee inherits role permissions automatically.

Every claim walks the same observable state machine: SUBMITTED → RECEIVED → IN_REVIEW → APPROVED → SETTLED, with side branches for QUERIED / RESUBMITTED and REJECTED.

• The queue ranks claims by AI risk score, SLA urgency, value and payer rules.
• Adjudicators see line items, eligibility verdict, benefit limits and AI-flagged anomalies side-by-side.
• Claims belonging to the same provider in the same billing month roll up into a Pile — with a "Vet next" workflow for batch vetting.
• Approved claims roll up into a settlement run on your chosen cadence.

• Urgency tiers: ROUTINE / URGENT / EMERGENCY each carry an SLA timer.
• Auto-approval rules: define per-plan, per-procedure rules; matches are approved instantly with an auth code.
• Ghost-patient alerts: an emergency PA notifies the enrollee directly, so the cardholder catches misuse.
• Appeals: rejected PAs can be appealed by the provider with new evidence.

• Settlement runs — group approved claims by provider, produce a remittance, attach the payment proof.
• Capitation — monthly per-enrollee payouts to designated primary providers.
• Payment proofs — uploaded by Finance; the provider portal shows them in real time.
• Disputes — providers raise disputes against remittances; Finance resolves with audit trail.

• Every claim is risk-scored on submission. Triggers: duplicate billing, impossible service dates, upcoding patterns, rapid-fire submissions.
• AiRiskEvent records every flag for auditability.
• The Fraud & anomaly report aggregates trends by provider, procedure and enrollee.
• Ask Vetra (the in-app AI copilot) summarises claims, surfaces similar past cases and drafts query responses.

• Loss ratio
• Claims utilisation
• Provider performance
• Claims aging
• Settlement summary
• Fraud & anomaly
• Authorisation
• Enrollee coverage

All eight ship with KPIs + trend + breakdown + filterable table + CSV export.

A real-time bell over SSE pushes events to staff, providers and enrollees:

• PA submitted / decisioned / appealed
• Claim submitted / queried / approved / rejected / settled
• Settlement run created, payment proof uploaded
• Suspicious activity (ghost-patient alerts)

• Tenant isolation — every HMO's data is logically isolated and scoped server-side.
• BFF architecture — the public app talks only to a backend-for-frontend; the core API requires an x-api-key.
• Auth — httpOnly cookies, helmet, throttling, CORS allow-list, environment validation.
• RBAC — 55+ permissions; approval limits as a second control layer.
• Audit log — every permission-sensitive action is append-only and exportable.
• Encryption — TLS 1.2+ in transit, AES-256 at rest, managed key rotation.