← All Use Cases

NHIS Claims Preparation & Rejection Prevention

Over 30% of NHIS claims are delayed or rejected on first submission. Your admin team is manually chasing every one of them.

Without Automation30%+ delayed or rejected
With Kwanex60–70% less admin time
The Problem

Nigerian private hospitals and clinics enrolled in the National Health Insurance Scheme face a consistent administrative burden that cuts directly into cash flow. Claims are assembled manually from patient records, referral letters, and treatment logs. Submission is done by hand. Rejections arrive weeks later with minimal explanation, requiring the entire process to restart. Each delayed claim means delayed revenue. Each rejected claim means unpaid work. And every hour your admin team spends on NHIS paperwork is an hour not spent on patient care.

The automation behind the outcome.

Layer 01

Eligibility Pre-Verification

Patient eligibility is verified before treatment begins — no surprises at submission time.

Layer 02

Auto-Assembly of Claims

Claim documentation is assembled automatically from existing patient records, referral letters, and treatment logs.

Layer 03

Submission & Follow-Up Tracking

Submissions are tracked end-to-end with automated follow-up triggers for outstanding claims.

Layer 04

Rejection Workflow

Rejections are categorised and routed into a re-submission workflow — no claim is forgotten.

Layer 05

Monthly Reconciliation

A monthly claims reconciliation report is generated automatically — submitted vs. paid vs. outstanding.

The Result

Facilities that automate this process typically recover 15–25% of previously delayed revenue within the first quarter, reduce admin time on claims by 60–70%, and cut rejection rates through pre-validation before submission.

Does this look like your facility?

We offer a free assessment to map your specific NHIS workflow. No commitment.