Insurance

Slade360 / SMART Integration

Real-time verification, pre-authorisation, claim submission and reconciliation with Slade360 and SMART platforms.

Overview

Insurance Without the Paperwork Pain

Slade360 and SMART are the two main electronic claims networks in Kenya, used by most major medical insurers. ClinixCore's direct integration means front desk verifies cover instantly, doctors get pre-authorisations during the consultation, and finance submits claims without ever leaving the system.

Real-time member eligibility verification
Online pre-authorisation requests
Automatic claim submission with ICD-10 / CPT codes
Claim status dashboard and rework alerts
Payment reconciliation against received settlements

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Slade360 SMART insurance integration with ClinixCore

Key Capabilities

What Slade360 & SMART Integration Delivers

Instant Verification

Front desk swipes the smart card or types the member number — eligibility and benefits return in seconds.

Online Pre-Auth

Doctors raise pre-authorisation requests inside ClinixCore, with diagnoses and proposed services pre-filled.

Automated Claim Submission

Closed encounters generate compliant claims and submit them in batches — clean coding cuts rejections.

Rejection Workflow

Rejected claims are tracked with reasons, reassigned for fixing, and resubmitted in a single workflow.

Settlement Reconciliation

When insurers pay, payments match individual claims — no spreadsheets, no missing money.

Insurance Analytics

Track approval rates, average reimbursement, top-rejecting payers and outstanding receivables.

Use Cases

Real Insurance Workflows

Outpatient Visit

Member verified at reception, doctor sees patient, services posted to invoice, claim sent automatically that evening.

Inpatient Pre-Auth

For admissions and procedures, ClinixCore raises pre-auth at admission and tracks it through the stay.

Co-Pay Handling

Where the patient owes a co-pay, ClinixCore splits the bill and takes patient share via M-Pesa or cash.