Health insurance infrastructure

Insurance that
works for
everyone.

SaKi connects patients, providers, insurers and TPAs on one real-time platform — instant pre-auth, automated claims, live actuarial intelligence.

See a Live Demo →How it works ↓
Doctor reviewing patient data on tabletMedical staff collaborating in modern hospitalSaKi platform dashboard showing pre-auth approval
Pre-auth approved
3 min 42 sec
✓
KES 2.4M paid
Facility A · Today
LivePre-auth approved3m 42s

Platform performance metrics

0%
Faster claims turnaround
0+
AI agents across the care loop
0%
Pre-auths auto-decided
0
Patient data leaving East Africa
What SaKi delivers

One platform.
Everyone served.

SaKi is real-time health insurance infrastructure for East Africa. Every decision — pre-auth, claim, consent, payment — happens on one shared platform, visible to the right people at the right moment.

Patients

Cover verified before you reach the ward. Consent signed at the bedside. Claim settled automatically.

  • ✓Real-time benefit visibility at point of care
  • ✓Digital consent in English or Swahili
  • ✓Claim status pushed to you instantly — no forms
Insurers & TPAs

94% of pre-auths decided automatically. Fraud flagged before payment. Loss ratios live.

  • ✓AI pre-auth in under 4 minutes
  • ✓Fraud, waste & abuse detection pre-payment
  • ✓Live actuarial intelligence and MLR dashboards
Providers

Pre-auth before the patient arrives. Digital admission in minutes. Payment tracked in real time.

  • ✓Paperless admission & instant eligibility check
  • ✓Auto-generated claims from clinical data
  • ✓Faster, predictable payment with live status
Patient data stays in East Africa — always. Fully self-hosted, no data egress.
Solutions

Four portals.
One shared truth.

Live claims visibility — AI assesses, routes, and auto-approves on your configured risk thresholds. 94% without human intervention.

Pre-auth at the point of care — decisions in under 4 minutes, COB and benefit exhaustion checks run automatically.

Fraud, waste and abuse caught before payment — overtreatment risk scoring, variance flags, pattern anomaly detection.

Actuarial intelligence — live loss ratios, utilisation trends, combined ratio projections.

Insurer Dashboard · Live
71.4%
Medical Loss Ratio
94%
Auto-decisions
Waste blocked · KES 12.4M
Providers paid <3 days · 89%
How it works

From arrival
to provider paid.

See the AI agents behind each step →
01
Patient arrives
Digital admission captures details, verifies cover instantly, and fires pre-auth — all before reception is finished.
02
AI decides
Pre-auth agent checks benefit limits, COB rules, overtreatment risk. Decision in under 4 minutes.
03
Encounter documented
Doctor portal captures procedures and diagnoses. Claims auto-generated from clinical data.
04
Provider paid
Claims assessed, approved and settled faster — waste controls running before any payment.
The AI layer

Eight agents.
One connected system.

Each agent owns a specific workflow. They share one real-time data layer — a decision in one instantly updates all others.

01
Claims Agent
AI triage, automated assessment, variance detection.
94% auto-decided
02
Pre-Auth Agent
Real-time PA decisions with COB and benefit checks.
Under 4 min
03
FWA Alerts
Overtreatment risk and billing anomalies before payment.
Pre-payment
04
Actuarial Intel
Live MLR, utilisation trends, combined ratio forecasting.
Real-time MLR
Trust is core infrastructure
Every AI decision — goal, inputs, outcome, and any policy flags — is logged to an immutable record. Any stakeholder can query exactly why a claim was approved or declined.
100%AI decisions logged
8agents scoped & sandboxed
Pricing

Pay only for decisions
actually made.

No flat fees. No member caps. Billed per pre-authorisation decision processed — your cost scales directly with activity.

Tier A
Outpatient
OPD · Specialist · Dental · Pharmacy
KES 100
per decision
Tier B
Diagnostics
Lab · Allied health · Physio · OT
KES 150
per decision
Tier C
Inpatient
Inpatient · Surgical · Maternity
KES 300
per decision
Invoices auto-generated monthly — itemised by category, volume, and tier. See a sample invoice →
Example Invoice — May 2026, Insurer AKES 196,000
Tier A · 820 × KES 100KES 82,000
Tier B · 340 × KES 150KES 51,000
Tier C · 210 × KES 300KES 63,000
1,370 decisions totalKES 196,000
Everything included
✓All 8 AI agents
✓Unlimited providers & members
✓Fraud detection pre-payment
✓Live loss ratio analytics
Full feature list →
Our story

Built in Nairobi,
for Africa.

SaKi is built by PharmaFinder Investments Ltd — a Nairobi-based health technology company connecting every party in the East African health insurance system on one real-time platform.

Built & owned by
PharmaFinder Investments Ltd
Nairobi, Kenya · All rights reserved
Current capabilitiesProduction-ready
✓8 AI agents covering the full care loop
✓Real-time payment confirmation for providers
✓Automated pre-auth with COB checking
✓Immutable AI decision audit trail
See full capability list →
→Tanzania & Uganda expansion · soon
Get started

Ready to run health insurance
the right way?

Talk to our team. We'll walk you through a live demo tailored to your organisation — whether you're an insurer, a TPA, or a provider ready to get paid faster.

Book a Live Demo →Contact our team

Deployed in East Africa · Patient data stays in-country · hello@saki.co.ke

A proprietary platform by PharmaFinder Investments Ltd, Nairobi, Kenya