Scheme Genius — Medical Aid Engine

Automated adjudication, flexible benefits, pre-auth, payment runs, analytics, and electronic claims connectivity.

Membership & benefits admin, claims capture/EDI, rules-driven adjudication, remittances & payment runs.

Rules mapping for complex corporate variants and micro-products; UI-driven configuration; provider web capture.

Provider switch; banking exports; ERP integrations; standards-aligned data.

Plan/region/demographic analytics (subs vs claims vs profit proxy), delinquency ratios.

Estimate savings from adjudication automation & delinquency improvement.