+254 722 427421
sales@cognaisure.com
Connecting the Health Insurance Landscape with AI-Driven Precision
Cognaisure is a next-generation, AI-driven health insurance technology platform built to modernize and streamline the entire health insurance value chain. Our cloud-hosted, 360° end-to-end solution connects all key stakeholders—including insurers, policyholders, healthcare providers, and regulators—into a unified, intelligent ecosystem.
We exist to simplify the complexities of health insurance through cutting-edge automation, secure integrations, and real-time data orchestration. By digitizing and optimizing core processes, Cognaisure helps organizations reduce operational inefficiencies, lower costs, and deliver better customer experiences.
Our platform enables smarter decision-making, faster processing, and seamless collaboration across the healthcare and insurance landscape. At Cognaisure, we’re not just building technology—we're reimagining the future of health insurance.
About Us
At Cognaisure, we empower the health insurance industry with smart, scalable, and future-ready technology. Our comprehensive platform connects insurers, policyholders, healthcare providers, and regulators—streamlining and optimizing critical functions such as policy administration, claims processing, fraud detection, and regulatory compliance.
By harnessing the power of AI, automated straight-through processing, IoT, and secure cloud infrastructure, we enable greater efficiency, transparency, and trust across the entire health insurance ecosystem.
Cognaisure is more than a technology solution—we are a catalyst for innovation, transforming traditional insurance operations into intelligent, agile systems that serve everyone better.
Trusted By 250+ Companies
Capabilities
Underwriting and Policy Administration
Claims Management
Portals and Mobile Apps
AI-Driven features
Claims Process
Step 1: Pre-Authorization Request
Lima goes to the hospital for treatment.
She shares her Policy No. or Mobile No. or Membership No. at the Reception or Insurance desk.
In LC360 provider portal, hospital executive can see the member information and high-level benefits eligibility
Step 2: Member Verification
Lima’s membership can be verified by any one of the LC360 advanced features
- Biometric Validation
- Facial Recognition
- OTP Based Validation
Step 3: Pre-Authorization Approval
Pre-Authorization evaluation by Rule Engine and subsequent approval for cashless hospitalization
Step 4: Case Management, Discharge and Claim Initiation
A detailed Case Management module to handle pre-hospital, in-hospital and post-discharge activities. Generative AI driven invoice automation for claim invoice processing.
step 5. Claims Audit and Payments
Approved claims are duly audited and marked as Ready for Payment in case they are in order. Integration with payment ERP solution ensures payment clearing and reconciliation.
Streamlined Claim Processing with Cognaisure
Cognaisure simplifies and accelerates the health insurance claim lifecycle—from hospital visits to final settlement—through intelligent automation, advanced validation, and seamless integrations.
Step 1: Pre-Authorization Request
When Lima visits the hospital for treatment, she provides her Policy Number, Mobile Number, or Membership ID at the reception or insurance desk.
Through the Cognaisure Provider Portal, hospital staff can instantly access Lima’s member profile and view high-level benefits eligibility, enabling quick initiation of the pre-authorization process.
Step 2: Member Verification
Lima’s identity is verified using one of Cognaisure’s advanced authentication methods:
- Biometric Validation
- Facial Recognition
- OTP Based Validation
These secure and user-friendly options ensure fast and accurate member verification at the point of care.
Step 3: Pre-Authorization Approval
Cognaisure’s intelligent Rule Engine evaluates the pre-authorization request in real time, checking for policy coverage, treatment eligibility, and clinical protocols.
Once verified, cashless hospitalization is approved, allowing treatment to begin without delay.
Step 4: Case Management, Discharge and Claim Initiation
Our robust Case Management module supports the entire patient journey:
- Pre-hospitalization tracking
- In-hospital documentation
- Post-discharge coordination
With Generative AI-powered invoice automation, claim documentation is generated and submitted seamlessly, reducing manual effort and errors.
Step 5: Claims Audit & Payment Processing
All submitted claims are subjected to automated audits for accuracy, policy compliance, and fraud detection.
Once approved, claims are marked Ready for Payment, and Cognaisure integrates directly with your ERP and payment systems to ensure timely settlement and reconciliation.
Delivering real value, every step of the way
Simplify. Optimize. Transform.
Secure what’s Important to you in just three steps
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Driven by Expertise. United by Innovation
At Cognaisure, our deep industry expertise and forward-thinking technology come together to transform the health insurance landscape—enabling smarter operations, seamless collaboration, and lasting impact.
Isaya Timona Francisco
Principal Domain Consultant
Certified Project Management Professional (PMP) with 20+ years of experience in systems development, IT infrastructure, risk management, and Privacy & Data Governance. Proven track record leading secure, scalable technology projects for insurance clients across East and Southern Africa, ensuring compliance and regional relevance.
Customer Says
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Romain Michel
Secure Your Future With Future-Insure
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