Get Paid Faster with Clean, Validated Claims
Scycare Claims standardizes diagnosis, procedure, lab, and medication codes — reducing rejected claims, accelerating reimbursement, and lowering adjudication costs for insurers, hospitals, and diagnostic labs across Ghana.
The clean-claims engine for Ghana’s health economy
A dedicated terminology and validation platform that sits between providers and payers to make sure every claim line is valid, covered, and standardized before it hits adjudication.
Clean-Claims Terminology Platform
Standardizes ICD, procedure, lab, and medication codes into payer-approved canonical terminology, eliminating inconsistent provider coding.
Pre-Submission Validation
Validates claim lines before submission — catching invalid or non-covered services early and reducing rework and back-and-forth.
Plan & Coverage Intelligence
Aligns claim lines with payer product and benefit structures, so everyone knows what is billable, when, and under which plan.
High-volume claims stakeholders across Ghana
Scycare Claims is built for organizations where claims volume, speed and accuracy directly impact financial performance.
Claims Processors & TPAs
Reduce adjudication workload, standardize incoming claims, and cut time spent resolving coding issues and rejections.
Insurance Providers
Enforce consistent coding across your provider network, reduce leakage, and support digital claims modernization.
Large Hospitals & Specialist Centers
Improve first-pass acceptance rates, shorten reimbursement cycles, and reduce administrative time spent fixing rejected claims.
Diagnostic Laboratory Networks
Ensure every lab test and panel is billed with the correct payer-recognised codes, even at very high daily claim volumes.
Pharmacy & Medication Claims
Normalize medication codes and ATC groupings, improving accuracy for drug and consumable claim lines.
Corporate & Occupational Health
Guarantee billable, standards-compliant claims for employee health programmes and corporate wellness packages.
A three-step model for clean, validated claims
Scycare Claims plugs into existing hospital, lab and payer systems without replacement — providing a shared layer for mapping, validation, and coverage alignment.
Provider Code Mapping
We align provider-specific codes with payer-approved canonical code sets, creating a shared source of truth for diagnoses, procedures, tests and medications.
Clean-Claims Validation
Before claims are submitted, Scycare validates each line for terminology correctness, completeness and internal consistency, dramatically reducing rejections.
Product & Coverage Alignment
Claim lines are checked against payer product and coverage rules, ensuring that only billable services move forward into adjudication.
Why high-volume stakeholders choose Scycare Claims
- Reduce adjudication time and manual review workload.
- Lower leakage and fraud exposure through standardized codes.
- Gain analytics-ready data across hospitals, labs & pharmacies.
- Support digital claims modernization without disrupting existing core systems.
- Increase first-pass claim acceptance and reduce resubmissions.
- Shorten reimbursement cycles and improve cashflow predictability.
- Reduce administrative time spent fixing rejected claims.
- Align internal billing systems with payer expectations using a shared terminology layer.
Enterprise-grade claims infrastructure
Scycare Claims is designed as a shared, secure layer between providers and payers — with clear separation between terminology, validation, and adjudication logic.
Data Inputs
Scycare Claims Core
Outputs
Built for Ghana, with global best practice
Ghana Health Financing Ready
Designed around the realities of Ghana’s insurance ecosystem — tariff lists, benefit packages, and evolving regulatory expectations.
Interoperable and Future-Proof
Ready for ICD-11, digital claims platforms, and broader Scycare interoperability initiatives across labs, pharmacies, and hospitals.
Secure & Enterprise-grade
Built with modern security practices, observability, and scalability in mind — suitable for national-scale deployment and high-volume providers.
Scycare enables sustainable, inclusive healthcare by connecting all stakeholders through modern infrastructure. Whether you're a ministry, development partner, or large healthcare network, we provide the backbone for Ghana's digital health transformation.
Ready to Eliminate Rejected Claims?
If you process or submit a high volume of claims in Ghana, Scycare Claims can help you move from manual fixes and uncertainty to clean, validated claims and predictable reimbursement.
Or reach out to hello@scycare.com | +233 54 311 6017
© 2025 Scycare • Claims Infrastructure for Ghana’s Healthcare Ecosystem