Early-stage company · South Africa

Healthcare claims integrity

A claim can look fine on its own. The pattern around it might not.

We're building Sequrin for medical schemes and claims-integrity teams to see how claims connect through providers, members, facilities, timing and related activity, so an investigation starts with more than one record in isolation.

Sequrin overview · 68 seconds
See how Sequrin moves from a signal to connected investigation context. English captions included.

The problem

Risk usually is not sitting neatly inside one claim.

A claim can look completely ordinary until you notice the same provider, timing, member or facility appearing somewhere else. The pattern is often in the relationships between records.

Sequrin is being built to pull that context into view early enough for an investigator to ask a better question.

01

Find what stands out

Rules, statistics and models help surface activity that is actually worth a second look.

02

See what connects

Network analysis shows how claims, members, providers, facilities and events relate to one another.

03

Investigate in context

Bring the signal, evidence, relationships and case history together instead of rebuilding the story across separate tools.

The approach

From something worth noticing to an investigation you can stand behind.

Analysis helps decide where to look. Investigators work out what the evidence means, and the organisation keeps the decision.

  1. 01

    Connect

    Bring the claims and reference data you actually need into one usable context.

  2. 02

    Detect

    Use rules, statistics, models and relationships to find activity worth a closer look.

  3. 03

    Investigate

    Review the evidence, linked entities and history behind the signal.

  4. 04

    Decide

    The call stays with the authorised people and processes responsible for it.

Company stage

Build it, test it, then earn the right to scale it.

Sequrin is early-stage. The immediate job is to prove that the product gives claims-integrity teams genuinely useful context before making bigger claims about scale or impact.

Now

Working prototype

The browser and desktop experiences are being developed around synthetic and development data.

Next

Controlled evaluation

Start with one bounded claims-integrity question, real investigator review and agreed measures of usefulness.

Longer term

Governed network intelligence

Only after the foundations hold up do we explore responsible collaboration across organisations.

Accountability

Signals are where the investigation starts.

Sequrin can point investigators toward unusual activity and give them better context. It does not make the consequential call for the medical scheme.

Read the governance principles

Start with a real question

Bring us one claims-integrity problem worth testing.

A useful first conversation is about the question, the data you have and what would count as evidence that Sequrin actually helped.