Built into the lab portal
HMO claims tracking, without the spreadsheet chase
Submit, age, and reconcile claims for Reliance, Hygeia, AXA Mansard, and 8 more HMOs — all from inside the lab portal. No separate tool, no extra fee, no monthly subscription.
New · HMO Billing
Stop chasing HMOs in a notebook.
Track every claim from booking through payment. Reliance, Hygeia, AXA Mansard, Avon, Total Health, and 6 more — built in, no extra setup. One flat fee per patient visit, no surcharge for HMO orders.
Awaiting HMO
₦26,250
3 claims pending settlement
HMO collected
₦8,400
2 claims paid
Lost to rejections
₦0
0 claims rejected
60-day overdue tag
Claims past 60 days flag automatically. Lab owner gets a weekly bell + email digest.
Bulk CSV export
Filter your claim list, export as CSV, upload to the HMO portal. Same row format every HMO accepts.
Co-pay split
Patient’s cash co-pay routes to the cash drawer separately. The claim amount stays accurate.
How the claim flow works
From order created to claim paid, in four steps
1. Order with HMO billing
Front desk picks HMO as the payment method, selects the insurer, and enters the member ID. Policyholder name auto-fills from the patient profile — or the primary's profile when the patient is a dependent.
2. Result approved at the lab
Lab tech enters results, approver signs off. The claim shape is set the moment the order is created, so approval doesn't need a separate billing step.
3. Submit to the HMO
From /lab/hmo/claims, filter by insurer or date range, export the rows as CSV in the format every HMO accepts, and upload to the HMO portal. The submitted-at timestamp is stamped automatically.
4. Payment reconciled
When the HMO pays (or rejects), the lab admin marks the claim status and amount. The aging dashboard updates, weekly digest stops nudging, and the cash drawer shows the HMO payment alongside cash receipts.
Supported HMO providers
11 HMOs built in, no extra setup
The claim builder ships with these insurers pre-configured. Pre-set settlement times power the 60-day overdue tag, default co-pay rates auto-fill, and your accountant gets the right CSV format every time.
More on the way. Tell us which insurer you use most via the Contact page if it's not on this list.
What makes this different from a spreadsheet
Generic LIMS products tack on a billing tab. This was built for lab claim workflows specifically.
Dependents auto-fill the policyholder
When the patient is a dependent (kid, spouse, elderly parent), the claim defaults to the primary's policy name. No more rejected claims because the child's name was on the policy line.
60-day overdue tag
Claims past 60 days flag automatically. The lab owner gets a weekly digest of what's overdue — no more chasing in a notebook.
Bulk CSV export
One row format every HMO accepts. Filter the claim list, export, upload to the HMO portal. No reformatting columns by hand.
Co-pay split
When the patient pays a cash co-pay, the platform routes that to the cash drawer and keeps the claim amount accurate. The aging dashboard tracks only what the HMO actually owes.
Questions labs ask about HMO claims
Do I need to set up integrations with each HMO?+
No. The claim builder produces a CSV in the standard format every HMO accepts. You upload the CSV to each HMO's portal — same way you'd upload a manual spreadsheet, except the data is pre-formatted correctly.
What if my insurer isn't on the list?+
Use 'Other' and type the insurer name as free text. The claim still gets tracked through the same workflow — aging, submission, payment — but won't get auto-filled defaults like Reliance or Hygeia where we've calibrated the typical settlement times.
Does this work for hospitals submitting tests to my lab?+
Yes. When a hospital sends an order through the partner portal, the HMO fields flow through with the order. Your lab tech sees the claim ready to go once approval is done — no re-entry.
Is there an extra fee for HMO orders?+
No. HMO orders cost the same as cash orders. There's no subscription, no per-claim fee, no co-pay surcharge. The HMO claim builder is included - see pricing for the per-order rate.
Stop losing claims to overdue tracking
Pay-as-you-go per order, HMO or cash. No subscription. Sign up your lab, fund a wallet, and the claim builder works on your first HMO order.