G8 Nexum - The Complete HMO Operating System for Nigerian Health Insurance

G8 Nexum · NHIA-Compliant · Built for Nigeria

G8 Nexum -
The Complete
HMO Operating
System

G8 Nexum gives your HMO one platform to run everything - claims, pre-auth, capitation, fraud detection, finance, and AI. Purpose-built for Nigerian health insurance operations.

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10×
Fraud checks run at submission, before payment
80%
Reduction in claims processing time
₦0
Duplicate claims paid undetected
hmo.g8brooks.com / dashboard
G8 Nexum main dashboard showing claims summary StatCards, HCP count, total paid this month, fraud alerts, and recent activity feed
Main Dashboard
StatCards row · Claims trend chart · Fraud alert count · Recent activity feed
Designed for operations like
Integrated HMOs State Health Insurance Agencies Multi-branch HMOs New Entrants NHIA-Accredited Operators
The Nigerian HMO Reality

83 HMOs. Most running on spreadsheets, WhatsApp, and hope. G8 Nexum changes that.

70%
of healthcare fraud goes undetected

In manual HMO operations, duplicate claims, tariff padding, and ghost enrollees are only discovered at year-end audit, after the money has left the building.

14+
days average claims processing time

Claims tracked in spreadsheets. Officers lose batches. No audit trail. HCPs frustrated by delayed payments. Corporate clients complaining about turnaround. SLAs broken weekly.

₦M+
lost annually per HMO to avoidable errors

Capitation calculated from guesses, not live headcounts. PA approvals existing only in someone's WhatsApp DM. No cross-HCP pattern visibility until the damage is done.

The Platform

Every module your HMO needs, inside G8 Nexum

G8 Nexum covers the entire operation, from the moment a claim is submitted to the moment payment hits an HCP's account. No gaps, no workarounds, no spreadsheets.

Claims Management

Structured digital submission, 10 automated fraud checks at entry, real-time status board, full audit trail on every action.

Pre-Authorisation

3-tier approval workflow, unique PA codes, TAT countdown timers, emergency 4-hour expedited path. No more WhatsApp DM approvals.

Enrollee Management

Members, dependants, bulk CSV import, live benefit tracking, digital health ID card, expiry alerts.

HCP Management

Accreditation records, agreed tariff schedules, blacklisting, performance scoring, capitation rates per tier.

Finance & Capitation

Monthly capitation cycle with live headcount snapshots, variance flagging, payment batching, bank file export.

Fraud Detection

10 automatic checks per claim plus monthly AI clustering that surfaces billing rings invisible to per-claim analysis.

Reports & Analytics

7 built-in report types - claims aging, loss ratio, HCP performance, cost by corporate - each with AI executive summary.

Three Portals

Staff portal, corporate client self-service portal, and member-facing enrollee portal, all included at no extra cost.

G8 Nexum · Claims Management
G8 Nexum claims list showing claim rows with Pending, Approved, and Rejected status badges, fraud score column, HCP name, ₦ amount, and action buttons
Claims List Page
Status badges · Fraud score column · Action buttons · Filter bar · Mixed claim statuses
Claims Management

Every claim tracked. Every action logged. Nothing falls through.

The claims list gives your team a real-time operational view. Filter by status, date, HCP, or corporate. Bulk-approve clean batches. Fraud-flagged claims surface automatically, no manual scanning.

  • 10 automated fraud checks fire before any claim is saved
  • Status badges: Pending, Under Review, Approved, Rejected, Queried
  • Full audit trail, every status change timestamped with actor
  • Bulk payment batching with one-click bank file export
G8 Nexum · Pre-Authorisation Detail
G8 Nexum pre-authorisation detail page showing 3-tier approval workflow stepper, unique PA code, TAT countdown timer, ICD codes, and approval buttons
Pre-Auth Code Detail
3-tier approval stepper · Unique PA code · TAT countdown · ICD codes · Approve/Query/Reject buttons
Pre-Authorisation

Structured approvals that replace the WhatsApp DM forever

Every PA request moves through a defined 3-tier workflow - Medical Officer → Senior Officer → CMO - with a unique PA code issued on approval. TAT timers enforce your SLAs automatically.

  • Unique PA code per approved request - HCP verifiable at point of care
  • TAT countdown visible to all approvers - no more missed deadlines
  • Emergency path: 4-hour turnaround for life-threatening cases
  • Full approval chain recorded - who approved, when, and with what notes
Fraud Detection

Stop losses before payment. Not after.

Most Nigerian HMOs discover fraud at year-end audit. By then, millions have already left the building. G8 Nexum runs 10 automated checks the moment a claim is submitted.

Duplicate Claim
Same member + HCP + date within 30 days
Tariff Mismatch
Amount exceeds agreed rate by >10%
Expired Plan
Service date after enrollee expiry
Frequency Anomaly
Same service 3× in 30 days
Cost Spike
Amount is 3× HCP's own average
PA Missing
High-cost claim lacks pre-auth
Blacklisted Provider
Claim from suspended HCP
AI Clustering
Monthly DBSCAN - surfaces billing rings
G8 Nexum · Claim Detail - Fraud Flags
G8 Nexum claim detail fraud flags panel showing HIGH RISK badges for duplicate claim and tariff mismatch, flagged ₦ amounts, and AI billing cluster alert
Fraud Flags Panel
HIGH RISK badges · Flag descriptions · ₦ amounts at risk · AI billing cluster alert at bottom
AI-Powered Operations

G8 Nexum is powered by AI - the most capable AI for medical documents

Document OCR

Upload a hospital receipt, PDF or image. AI reads it and extracts patient name, diagnosis, itemised procedures, and total amount. Zero manual re-entry.

Claim Classification

Paste claim text - AI identifies claim type, suggests ICD-10 codes, flags if PA is required, and gives a confidence score with reasoning.

Smart Routing

AI analyses risk score, amount, fraud flags, and PA status to recommend the correct processing queue and urgency level for every claim.

Report Summarisation

Every report has an AI Summary button. Returns a 2-sentence executive brief, 5 bullet insights, and one actionable recommendation. Instantly.

Fraud Clustering

Monthly DBSCAN machine learning over all fraud flags. Surfaces billing rings invisible to per-claim analysis. Each cluster labelled in plain English.

AI Chat Assistant

Staff ask claims workflow and NHIA regulation questions. Enrollees ask benefit questions via HealthBot. Three persona modes. 24/7, no call centre.

G8 Nexum · Reports & Analytics
G8 Nexum reports page showing claims analytics StatCards, claims aging table, and the AI Summary side panel open with executive brief and 5 bullet insights
Reports + AI Summary Panel
StatCards row · Claims aging table · AI Summary panel open (executive brief + 5 bullets + recommendation)

AI features degrade gracefully - always

If AI is temporarily unavailable, the system shows an amber banner and falls back to rule-based logic. No broken pages. No crashed workflows. Ever.

Fallback
Rule-based
Uptime
99.5% SLA
Pricing

Straightforward plans for every HMO size

All plans include a 30-day satisfaction guarantee. If the system doesn't meet specification, we refund your first payment.

Starter
₦3.6M/year

For regional HMOs, TPAs & startups

  • Up to 5,000 enrollees
  • Full claims, PA, capitation, finance
  • NHIA compliance module
  • 3 branches included
  • Email & chat support
⭐ Most Popular
Growth
₦7.2M/year

For established HMOs with 10k–50k enrollees

  • Up to 50,000 enrollees
  • Everything in Starter +
  • Corporate & Member portals
  • Advanced fraud detection + AI
  • Unlimited branches & users
  • Dedicated account manager
Enterprise
₦14.4M/year

For national HMOs, SHIA, government

  • Unlimited enrollees
  • Everything in Growth +
  • White-label (your brand)
  • Self-hosted / on-premise
  • Source code available
  • 24/7 priority support + on-site
  • Custom integrations & training
Outright
₦24M one-time

Own the software forever

  • Full source code ownership
  • Self-hosted on your servers
  • White-label (your brand)
  • Unlimited enrollees & branches
  • All Enterprise features
  • 1 year support included

All plans include onboarding & training. Talk to us about custom pricing for SHIA or government-affiliated HMOs.

Enterprise-grade access control, included in every plan

Role-based permissions mean each user only sees and does exactly what their role allows. Claims officers can't touch finance. Branch staff can't see other branches. Configurable from day one.

  • Granular permission matrix - per module, per action
  • Pre-built roles: CEO, Branch Manager, Claims Officer, Finance Officer, Compliance
  • Custom role creation for your org structure
  • Full audit log of every permission change
G8 Nexum · Settings - User & Role Management
G8 Nexum user management page showing user list with role badge pills (Admin, Claims Officer, Finance Officer), branch assignment, active/suspended status, and role assignment panel
User & Role Management
User list · Role badge pills · Branch column · Active/Suspended status · Role assignment panel
Free Demo

See G8 Nexum live, with your own workflows

No slides. No generic demo. We walk through your actual claims process, your fraud scenarios, your capitation challenges, in the live system.

60-minute live walkthroughBring your operations team and ask real questions about your real workflows.
Scheduled within 48 hoursWe confirm your session via WhatsApp and send a calendar invite.
30-day satisfaction guaranteeIf it doesn't meet specification after deployment, we refund your first payment.
Prefer WhatsApp?Click the button on the form to open a direct chat, we respond within the hour.
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