Aegis Claims
Cost Optimization AI · Uganda
Built for Ugandan health-insurance reviewers

Stop overpaying on hospital claims.

Aegis predicts the reasonable cost of every claim in UGX, flags suspicious billing patterns from hospitals across Mulago, IHK, Mbarara and Lacor, and explains every recommendation in plain language. The AI never auto-denies. Humans always decide.

Free 14-day evaluation · No credit card · Approved within 1 business day

AI · Active
CLM004271 · NakaseroRisk 82
USh 8.4MPredicted reasonable cost
Hospital asks
USh 22.0M
AI delta
+162%
USh 4.2B
Claim volume scored in active pilots
18%
Average over-billing surfaced per cycle
< 200ms
Ultra-fast per-claim risk scoring
100%
Human-in-the-loop final review
How it works

From a noisy CSV to confident decisions in three steps

Aegis plugs into your existing claims pipeline. No need to change how providers submit data.

01

Upload claims data

Drop in a CSV from your TPA or HMIS export. Aegis preprocesses, deduplicates, and validates every row.

02

AI scores every claim

A cost-prediction model produces an expected UGX range. An anomaly engine flags outliers and assigns a 0–100 risk score.

03

Reviewers decide

Your team sees flagged claims with plain-English explanations and approves, adjusts, or escalates them.

What's inside

Everything a Ugandan claims team needs in one console

Six capabilities working together to protect every shilling your members contribute.

Reasonable cost in UGX

Per-claim predictions calibrated against peer providers in the same region — Central, Eastern, Western, Northern, West Nile, Karamoja.

Anomaly & fraud signals

IQR cost outliers, length-of-stay percentiles, provider over-billing patterns, and duplicate-claim detection — combined into one risk score.

Explainable recommendations

Every flag ships with the reasons in plain English so your reviewers can act in seconds, not hours.

Provider analytics

See which hospitals consistently bill above peer rates and where your cost growth is concentrated.

Live dashboards

Total claimed vs. predicted reasonable, monthly trends, risk distribution — all in one view for management.

Role-based access & audit

Reviewers, analysts and administrators each get the right view. Every decision is recorded for audit.

Compliance & ethics

Built for human-in-the-loop review

Every safeguard your compliance officer will ask about — designed in, not bolted on.

  • The AI never auto-denies a claim — every decision goes through a human reviewer.
  • Patient identifiers can be anonymized before processing.
  • Role-based access control with full audit logging of reviewer actions.
  • Aligned with the Uganda Data Protection and Privacy Act (DPPA).
Sample explanation a reviewer sees
CLM004271 · Nakasero Hospital
Risk score: 82 / 100 — High
  • • Claim amount is 162% higher than the predicted reasonable cost (USh 8,400,000).
  • • Length of stay (14 days) is unusually high for this diagnosis (typical ≤ 6 days).
  • • Provider's average claim exceeds the regional average by 35%.
Recommended action: Send for manual review
Access

Pick the right way to get started

Every plan ships the same AI engine. Pick how much production data and how many reviewers you need.

Guided demo

Free30-minute walkthrough

See Aegis run on synthetic Ugandan claims with one of our engineers. No setup required.

  • Live demo on real Ugandan procedures
  • Sample dashboard & risk scores
  • Q&A with our ML team
  • Compliance & DPPA briefing
Book demo access
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Free trial

14 daysNo credit card

Full reviewer access in a private sandbox loaded with synthetic claims from Ugandan facilities.

  • Up to 5 reviewer seats
  • Upload your own CSV claims
  • All dashboards & risk scoring
  • Email support, 1-business-day approval
Start free 14-day trial

Production

CustomAnnual contract

For insurers ready to deploy Aegis on live claims volume across multiple regions.

  • Unlimited reviewer seats
  • Custom model retraining on your data
  • SAML SSO & dedicated audit log
  • Onboarding & SLA-backed support
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Ready to see your numbers?

Request access now — your administrator typically approves new accounts within one business day.