Sonecare

Sonecare is the operating system for Nigeria's HMOs and providers — a multi-tenant SaaS that spans the full revenue cycle (enrollment, encounters, preauthorization, claims, settlement, analytics) plus the admin layer that makes it trustworthy (RBAC, workflows, subscriptions). Four factions share one platform and one audit trail: payers, providers, employers, and regulators. Built to the NHIA 2025 spec, not adapted from a US template.

Enrollment & eligibility

Enrollee lifecycle, dependents, plan assignment, member cards, and coverage verification at service date. Bulk CSV import for corporate clients.

Coverage & plans

Versioned health plans and benefit groups. Every plan change creates a new immutable version, so claims submitted under an older tariff aren't retroactively nuked when NHIA raises rates (as they did in April 2025 — FFS +378%, capitation +93%).

Provider network

HMO–provider agreements, onboarding invitations, status tracking across the facility network.

Encounters, preauth & verification

Providers initiate visits and declare what they're rendering. A 42-step benefit verification engine checks eligibility, facility level, quantity caps, tariff ceilings, copay rules, dependent coverage and POA logic before preauth is even requested. Authorization codes are issued per-benefit with the NHIA 1-hour SLA tracked.

Claims & settlement

Monthly claim batches, per-line adjudication with NHIA-standard denial reason codes, versioned decisions (v1 initial, v2+ appeals — nothing is ever erased), and remittance tracking against the 60-day settlement window.

Analytics

Faction-specific dashboards — payers see denial rate and AR aging; providers see payment timelines and peer benchmarks; clients see utilization. One /analytics URL, four dashboards, dispatched by organization type.

Admin & RBAC

The piece most claims platforms overlook. Each organization owns its structure — profile, feature access, branches, departments, teams, staff — and governs access through a four-layer RBAC (platform subscription → org subscription → org settings → user permission) with granular module:action codes.

Billing & subscriptions

Platform-tier subscriptions, per-item billing cycles, invoices.

Stack

Area	Tools
Programming Languages	Python, TypeScript, JavaScript
Backend	Django REST Framework, Celery, Redis, PostgreSQL
Frontend	React 19 + Vite + RTK Query + MUI; Next.js 16 for the marketing site
Infrastructure	Google Cloud (Cloud Run, Cloud Storage, Secret Manager, Cloud Build)