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 G8.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
Deployment & Licensing

Flexible deployment options for every HMO structure

Whether you're an emerging HMO, a multi-branch operator, or a government-backed scheme, G8 Nexum adapts to your operational scale, compliance requirements, and deployment preferences.

Starter

Ideal for emerging HMOs, TPAs, and regional operators building structured internal operations.

  • Claims & pre-auth workflows
  • Capitation management
  • NHIA-ready operational structure
  • Role-based access control
  • Cloud deployment
⭐ Recommended
Growth

Designed for established HMOs managing larger enrollee bases, multiple branches, and more advanced operational workflows.

  • AI-assisted validation & anomaly checks
  • Corporate & member portals
  • Advanced audit tracking
  • Multi-branch operations support
  • Dedicated onboarding support
Enterprise

Built for national HMOs, SHIA programs, enterprise healthcare operators, and large-scale institutional deployments.

  • Unlimited operational scale
  • Self-hosted or hybrid deployment
  • Custom integrations & APIs
  • Advanced security & audit controls
  • Training & enterprise support
Private Licensing

Available for organizations seeking dedicated infrastructure, white-label deployment, or long-term institutional ownership models.

  • White-label deployment
  • Dedicated infrastructure options
  • Custom operational workflows
  • Institutional deployment support
  • Extended technical partnership

Every deployment includes onboarding, workflow configuration, and operational guidance tailored to your organization structure.

Enterprise-grade access control included across all deployments

G8 Nexum uses structured role-based permissions to ensure operational separation across claims, finance, compliance, branch operations, and executive oversight.

  • Granular permission matrix by module & action
  • Predefined operational roles
  • Custom role creation for internal structures
  • Full audit logs for accountability & compliance
G8 Nexum · Settings - User & Role Management
G8 Nexum user management interface
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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