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CoverSelf Secures $8.2m to Drive Healthcare Claims, Scale Operations

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CoverSelf Beenext 3one4 capital $8.2m seed funding

By Dipo Olowookere

A unified platform for healthcare claims and payment integrity, CoverSelf, has obtained an $8.2 million seed round to expand its operations in the United States and drive healthcare claims and payment accuracy.

It was gathered that existing investors in the firm, BEENEXT and 3one4 Capital, led the funding round, with Z21 ventures and healthtech leaders coming in to invest in the organisation.

CoverSelf intends to use the fresh capital to build generative AI capabilities and increase headcount in sales and marketing as the business scales, especially at a time when the exponential growth of costs in healthcare remains hotly debated.

Over $4.1 trillion is spent on healthcare every year in the US alone, with administrative spending accounting for approximately one-quarter of the total amount.

In the last 12 months, the company has piloted the platform and successfully proved the platform’s readiness and effectiveness.

This has translated to two deployments for insurers where the platform processes 25 times more claims in the same time window than was done earlier.

Also, the platform has identified significant savings even after other vendors process claims. CoverSelf is in advanced discussions with 2 of the top 15 plans to collaborate. The current pipeline includes five of the top 15.

Traditional 3rd party payment integrity solution vendors exploit payment inaccuracies, which negatively impacts the provider’s experience and trust in payers and ends up ballooning waste and improper payments. With CoverSelf, payor payment integrity teams can reduce healthcare costs transparently and collaboratively with providers.

“The current claims integrity systems are very complex, and the deployed technologies are antiquated. Significant software innovation is needed to address the broken system that is currently creating out-of-control healthcare costs and waste.

“The cobbled-together software solutions result in scattered data and the inability to make real-time business decisions.

“Administrative complexity costs billions annually, an open and collaborative platform can significantly reduce the repetitive administrative costs,” the co-founder of CoverSelf, Rajasekhar Maddireddy, commented.

“Our solution offers multiple points of integration and intervention for all pre and post-pay payment integrity, effectively reducing waste.

“CoverSelf is empowering subject matter experts (SMEs) with a modern UX/UI that’s super easy to work with and aids them by eliminating technical dependencies thereby maximizing efficiency, and fostering rapid innovation.

“Speed to release has shifted from weeks to mere hours, thanks to our collaborative approach and operational efficiency,” the co-founder of the company, Raghavendra Pawar, also said.

Also commenting, the Managing Partner at BEENEXT, Dirk Van Quaquebeke, said, “CoverSelf’s vision to democratize the healthcare claims and payment integrity industry with their fully open and transparent solution built with a spirit of collaboration is truly inspirational,” while the VP for Investments at 3One4 Capital, Sonal Saldanha, noted that, “By bringing the payment integrity solution in-house, CoverSelf shifts the control of payment integrity from traditional outside vendors to payers. As payers start using CoverSelf, they will progressively need fewer external payment integrity vendors. Ultimately, CoverSelf will be the only payment integrity platform anyone will ever need.”

CoverSelf was established in 2021 by seasoned US healthcare domain experts to democratize the healthcare claims and payment integrity industry by creating a first-of-its-kind fully open and transparent solution that empowers payment integrity teams in health insurance companies (payers) to transparently resolve health claims with hospitals and medical practices (providers).

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SUNU Health Backs NHIA’s One-Hour Authorisation Policy

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One-Hour Authorisation Policy

By Modupe Gbadeyanka

The new one-hour authorisation response time ultimatum policy introduced by the National Health Insurance Authority (NHIA) has received the full backing of SUNU Health Nigeria Limited.

This policy was introduced by the agency to ensure enrollees get prompt approval codes to access care.

Healthcare service providers have been urged to report any Health Maintenance Organisation (HMO) that violates this initiative through an email, with the HMO in copy and a timestamp attached as evidence of the request. They may proceed to offer services to enrollees thereafter.

Speaking at the company’s second-quarter Providers’ Forum for the Lagos-Ogun region in Lagos recently, the chief executive of SUNU Health, Dr Moyosore Olomola, expressed optimism that this policy would improve healthcare delivery in the country, especially for enrollees, who crave quality service.

At the event themed Improving Quality and Access to Care Through Stronger Provider Network, and held at the Nigerian Institute of Medical Research (NIMR) in Yaba, Lagos, Mr Olomola reaffirmed the HMO’s commitment to operating within legal and operational frameworks to guarantee adequate care for enrollees.

“Access to care and quality of care remain key priorities in our healthcare systems. We know quite well that deliberate collaboration, strategic partnerships, and a shared commitment to excellence are required to achieve these priorities.

“A strong provider network is doubtless the backbone of any effective healthcare system. It ensures that our mutual enrollees receive the right care, at the right time, in the right place, and at the right price,” Mr Olomola, represented at the programme by the organisation’s Chief Operating Officer (COO), Dr Faith Nwachi, stated.

He further assured that SUNU Health would strictly adhere to the one-hour authorisation limit, stressing that this aligns seamlessly with one of the organisation’s core values—promptness and its corporate slogan, Humanity is the centre of our initiatives.

In a bid to further improve access and quality of care, SUNU Health also demonstrated its new operational software and Mobile app, aptly named SUNU Legacy.

Also speaking at the event, the NHIA Lagos State Coordinator (Ikeja), Dr Bethuel-Kasimu Abraham, noted that the forum’s expected outcome is to significantly reduce delays in accessing medical care.

Other key expectations include ensuring continuity of care, improving patient outcomes, and strengthening accountability among HMOs.

Addressing specific pain points faced by enrollees, the NHIA Ogun State Coordinator, Mr Dare Adefeso, acknowledged that the agency had received complaints regarding out-of-stock drugs and the discrimination of enrollees by certain providers.

He affirmed that the NHIA is actively addressing these issues, stressing that moving forward, every facility must ensure enrollees are properly catered to regardless of their status, provided they have an active health insurance plan.

Corroborating the long-standing legacy of SUNU Health, the Ogun State Director of the National Orientation Agency (NOA), Mrs Aishat Tiamiyu, shared that her agency is responsible for public information dissemination and has been enrolled with SUNU Health for over 25 years.

Commending the HMO’s stellar service over two decades, she called for the immediate enrollment of new NOA staff into the scheme.

The Providers’ Forum remains one of the strategic channels employed by SUNU Health to consistently engage healthcare providers, understand their operational challenges, introduce new software updates, and solidify partnerships aimed at fostering premium healthcare delivery across Nigeria.

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NAFDAC Announces Recall of WAP Sensual Enhancement Capsules

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WAP Sensual Enhancement Capsules

By Aduragbemi Omiyale

The National Agency for Food and Drug Administration and Control (NAFDAC) has announced the recall of a sexual enhancement product known as WAP Sensual Enhancement Capsules.

In a statement on Monday, the Nigerian agency disclosed that the recall is due to “undeclared pharmaceutical ingredients” in the product, whose country of origin is unknown, but is marketed and distributed online in the US through eBay.

It was emphasised that the recall is being “voluntarily” made by the manufacturer, Best Supplements Best Prices Company.

The detection of the undeclared pharmaceutical ingredients was made by the US Food and Drug Administration (FDA).

Laboratory analysis by the US FDA revealed that the product contained undeclared sildenafil, tadalafil, and flibanserin, which were not mentioned on the product label. Such substances may include phosphodiesterase type-5 (PDE-5) inhibitors or related compounds commonly used for the treatment of erectile dysfunction, the statement by NAFDAC stated.

Sildenafil and tadalafil are ingredients in FDA-approved prescription drugs used to treat erectile dysfunction.

It was noted that these undeclared ingredients may interact with nitrates found in some prescription drugs, such as nitroglycerin, and may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates.

Flibanserin is the active ingredient in an FDA-approved prescription drug used to treat low sexual desire in women. Flibanserin can cause drowsiness, sedation, dangerously low blood pressure, and fainting, especially when combined with alcohol.

Consumers have been encouraged to report compromised products (medicines or medical devices) to the nearest NAFDAC office, call 0800-162-3322, or send an email to sf******@********ov.ng.

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Tinubu Chooses Obi Adigwe Coordinator of Health Tech Data Analytics Office

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obi adigwe

By Modupe Gbadeyanka

Dr Obi Adigwe has been appointed as the pioneer National Coordinator of the National Health Technology and Data Analytics Office (NHTDAO).

The body was created by the Ministry of Health under the approval of President Bola Tinubu.

NHTDAO will be domiciled in the Office of the Coordinating Minister of Health and Social Welfare, a statement on Friday by the Special Adviser to the President on Information and Strategy, Mr Bayo Onanuga, stated.

The agency will serve as a meta-level national platform for coordinating the country’s digital-health agenda. It will reinforce, not replace, the existing statutory functions of relevant departments and agencies, it was emphasised.

The organisation will also harmonise and empower the public and private institutions across the health system, set the standards that connect them, and operationalise the National Digital Health Architecture, approved by the National Council on Health in November 2025.

It was stated that President Tinubu expects NHTDAO to accelerate Nigeria’s transition to a secure, interoperable and data-driven health system that improves outcomes for all citizens.

Mr Adigwe, as Director General of the National Institute for Pharmaceutical Research and Development, has leveraged science to catalyse interventions in artificial intelligence, translational research, and technology transfer.

He coordinated major projects, including the ¥300m Nanotechnology grant and the AFREXIMBank grant for Africa’s first API Training Facility. He led the roadmap development that underpinned an €18 million EU grant, the largest in Africa for the thematic area. During the last pandemic, Adigwe globally showcased African science by undertaking the world’s first analysis to debunk claims about the Covid Organics preparation.

The Office’s Steering Committee, which provides strategic direction and oversight, comprises:

  • Professor Muhammad Ali Pate, Coordinating Minister of Health and Social Welfare (Co-chair)
  • Mr Olaniyi Yusuf, Chairman of the Nigerian Economic Summit Group (Co-chair)
  • Dr Iziaq Adekunle Salako, Minister of State for Health and Social Welfare (Alternate Co-chair)
  • Ms Kachollom Daju, Permanent Secretary, Federal Ministry of Health and Social Welfare
  • Mr Idris Alubankudi Saliu, Special Adviser to the President on Technology and Digital Economy
  • Dr Muntaqa Umar-Sadiq, National Coordinator, SWAp Coordination Office
  • Dr Abdu Mukhtar, National Coordinator, Presidential Initiative to Unlock Healthcare Value Chain
  • Dr Muyi Aina, Executive Director, National Primary Health Care Development Agency
  • Dr Kelechi Ohiri, Director General, National Health Insurance Authority
  • Director, Health Planning, Research and Statistics, Ministry of Health and Social Welfare
  • National Information Technology Development Agency Representative
  • Six representatives of the State Commissioners of Health, one from each of the six geopolitical zones
  • Pharm Hamza Buhari, Stakeholder representing Industry and Community.
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