# M\-TIBA > Health insurance technology platform connecting payers, providers, and members across Africa ## At a glance | Field | Value | | --- | --- | | Category | Core Administration | | Type | Solutions Provider | | Region | EMEA | | Headquarters | Nairobi, Kenya | | Founded | 2015 | | Stage | Growth | | Employees | 51-200 | | Funding | Seed | ## Overview M-TIBA is a health insurance operations platform for insurers, governments, and donor-funded health programs in sub-Saharan Africa and the Middle East. The company provides end-to-end insurance administration technology that connects payers, healthcare providers, and members via mobile infrastructure, reducing the cost of managing a health insurance portfolio. The platform delivers automated pre-authorization, real-time claims processing, fraud detection, member management, and a provider network portal. Delivered as SaaS and integrated with M-PESA for mobile money payments, it reduces administrative cost per member from approximately USD 29 to USD 1 annually, and cuts claims turnaround from 77 days to under three hours. The system supports micro-insurance schemes designed for low-income populations alongside commercial health portfolios. M-TIBA serves 20 payers across Africa and has processed coverage for over 4.8 million lives. Customers include Jubilee Health Insurance, AAR Insurance, and RGA. The company holds ISO/IEC 27001:2013 certification and received Blue Company Certification in August 2025 for ethical business standards. M-TIBA was originally formed as a joint venture between CarePay International and PharmAccess Foundation. ## Products & services ### Member Experience Platform A branded mobile application for insurance members providing real-time claim status, instant benefit verification, and digital insurance ID cards. Members access health benefits via mobile, reducing manual calls and improving engagement. **Key features:** - Real\-time claim visibility - Instant benefit checks - Digital member ID cards *Target users:* Health insurance policyholders and scheme members ### Connected Operations Automated workflows for pre-authorization and claims processing, including straight-through processing and real-time fraud detection. The system reduces manual intervention in claims handling. **Key features:** - Automated pre\-authorization workflows - Straight\-through claims processing - Real\-time fraud detection - Reported 80% reduction in claims handling costs *Target users:* Health insurers, managed care organizations, government health agencies ### Data & AI Layer Analytics capabilities for actuarial pricing, portfolio cost monitoring, and risk management. AI-driven tools help insurers optimize pricing decisions and detect anomalies in claims data. **Key features:** - Real\-time actuarial analytics - Cost monitoring dashboards - AI\-assisted pricing optimization *Target users:* Actuaries, portfolio managers, chief underwriting officers ### Claims Management Dashboard A case management interface for claim processors and operations staff to manage workflows and track resolution status. **Key features:** - Workflow management for claims staff - Portfolio performance tracking - Reported 500% increase in daily claims processing capacity *Target users:* Claims teams at health insurers and TPAs ### Provider Network Portal Digital portal for healthcare providers enabling eligibility verification and pre-authorization submission. **Key features:** - Digital eligibility checks - Pre\-authorization request submission - Provider network onboarding *Target users:* Hospitals, clinics, and healthcare providers in partner networks ## Category & focus - Subcategories: Claims Management, Member Administration, Provider Network Management - Insurance verticals: Health - Target customers: Carriers, TPAs ## Notable customers - Jubilee Health Insurance - AAR Insurance - RGA - Aspire - Transnep Insurance Brokers ## Links - Website: - Directory profile: - Linkedin: - Press/news: --- *Last updated: 2026\-06\-22*