For HMOs & insurers
Run your entire claims operation, in one place.
Vetra replaces the spreadsheet stack with an intelligent system of record - real-time eligibility, automated vetting, AI fraud scoring, and one-click settlements for every provider on your network.
Vetted today
₦4.2M
Benefit engine
Adjudicate every claim line against your real tariff
Your published tariff goes in as-is. Vetra parses every rule - annual limits, session caps, waiting periods, copays, age and gender gates, conditional coverage - and applies them per claim line, with a human-readable reason on every decision.
- COVERED, LIMIT, SESSIONS, DAYS, COPAY, CONDITIONAL, EMERGENCY rules - all native
- Per-plan × per-service coverage matrix, versioned so amendments never overwrite history
- CSV import for your existing tariff document - no vendor change-request
One platform, every workflow
Pick the moment that matters to your team
Vetting in seconds, decisions you can explain
Claims land pre-routed by AI risk score - low-risk auto-approve, mid-risk to a vetter, high-risk to a senior reviewer. Every line item carries the engine's reason, so a queried claim can be defended in front of the provider, not just stamped.
- Auto-routed lanes: AUTO_APPROVE / STANDARD / SENIOR
- Per-line decisions with human-readable rationale
- In-thread queries to providers, with full claim history attached
Why Vetra
The first platform built for how Nigerian HMOs actually operate
Most claims platforms ask you to bend your tariff, your provider relationships and your finance workflow to fit a generic schema. Vetra is the opposite - your matrix, your tariff bands, your settlement cycles, all native. And you only pay for processed claims, so growth on your book never becomes a tax on your margin.
Run the whole operation in one place
Automated vetting
Rules, tariff and policy checks applied the moment a claim lands.
AI fraud intelligence
Catch duplicates, upcoding and anomalies before you pay.
Settlement engine
Batch, approve and pay providers, then auto-reconcile.
Instant eligibility
Verify members against the structured Member ID schema in milliseconds.
Approval controls
Role templates, approval limits and immutable audit logs.
Loss-ratio analytics
Utilization, leakage and latency in living dashboards.
What this means for your business
Drive better outcomes than legacy systems
HMO FAQ
Frequently asked questions
Answers for HMO leaders, operations teams and implementation owners evaluating Vetra.
How quickly can an HMO start using Vetra?
Most teams can start with a configured sandbox once their plans, tariff rules and provider list are shared. Production rollout depends on data quality, approval flows and how many provider or employer portals you want live on day one.
Can Vetra handle our existing tariffs and benefit rules?
Yes. Vetra is designed around real HMO tariff matrices, including annual limits, waiting periods, session caps, copays, conditional benefits, exclusions and per-service rules.
Do providers and employers need separate systems?
No. Providers, employers, enrollees and HMO operations teams each get role-specific portal access while working from the same underlying claims, eligibility and settlement data.
Does AI make final claim decisions?
AI helps route risk, identify anomalies and explain likely issues. Your clinical and operations teams still control final approval, rejection, query and escalation decisions.
How do settlements work?
Approved claims can be grouped by provider and billing month, reviewed through your approval controls, paid as a batch and reconciled against remittance data.
How is HMO data protected?
Vetra uses tenant isolation, role-based access, encryption in transit and at rest, and audit trails for sensitive operational actions across the platform.
See your tariff inside Vetra in 48 hours
Share your benefits matrix and we'll have a working sandbox configured for your team - your plans, your providers, your data.