Purpose-Built Technology for Uganda's Medical Insurance Market
Medvex operates on a cloud-hosted health administration platform configured for Ugandan regulatory requirements, UGX billing, and mobile money disbursement. It is the operational backbone behind everything we do.
Platform Modules
Claims Management
Electronic claims receipt, automated triage, a rules-based adjudication engine, payment processing, and a full audit trail. Supports both paper and digital submission from providers.
Pre-Authorisation Portal
Web and mobile portal for hospital and clinic pre-authorisation requests. Clinical decision support tools for case managers. Real-time status tracking for providers and members.
Provider Network Management
Provider credentialing database, agreed fee schedule management, direct billing contract tracking, and provider performance scorecards for every facility and practitioner in our network.
Member Portal and App
Benefit confirmation, pre-authorisation requests, claim status tracking, digital member card, and provider finder. SMS and WhatsApp integration for low-bandwidth environments.
Analytics and Reporting
Real-time client dashboards showing loss ratio, utilisation by benefit class, top diagnoses, provider utilisation league tables, and IRA regulatory reporting outputs. Data available on demand, not just at month end.
Fraud Detection
Rules-based detection of duplicate claims, billing anomalies, upcoding patterns, and outlier provider behaviour. A clinical review workflow routes all flagged cases to our clinical team for assessment.
Data Security and Compliance
- Cloud-hosted infrastructure fully compliant with the Uganda Data Protection and Privacy Act, 2019
- End-to-end encryption of all member health data
- Role-based access control with full audit logging for every claims decision
- Disaster recovery and business continuity capabilities with defined recovery time objectives