MediSmarts
MediSmarts is a Nigerian health technology company that provides Medicloud, a cloud-based enterprise platform integrating HMOs, healthcare providers, and insurance enrollees for claims adjudication, pre-authorization, and health insurance operations management.
- Company typePrivate
- Founded2015
- HeadquartersSuru-lere, Nigeria
- Headcount1–10
- GTM typeB2B
- OfferingSoftware
What MediSmarts does
MediSmarts (legal entity Medismarts Inc.) is a Nigerian health technology company that develops and sells cloud-based enterprise software connecting Health Maintenance Organizations (HMOs), healthcare providers, and insurance enrollees. Its core platform, Medicloud, is an end-to-end enterprise solution for managing day-to-day health insurance operations, including AI-powered automatic claims adjudication, pre-authorization workflows, business rules engines, and HMO-provider communication portals. The product suite is built on a platform-plus-modules architecture, with Medicloud as the core system and add-on modules for Electronic Medical Records (EMR), Telemedicine, Payment Integration, and Business Analysis. MediSmarts claims to be the first Nigerian company to build an integrated HMO-provider portal, a mobile app for health insurance access, and a cloud-based claims automation engine, and the platform is delivered with out-of-the-box APIs for integration with CRM, telehealth, and partner distribution platforms.
MediSmarts firmographics
Firmographics- Name
- MediSmarts
- Legal name
- Medismarts Inc.
- Website
- https://medismarts.com.ng
- Company type
- Private
- Founded year
- 2015
- Operating status
- Operating
- Headcount range
- 1–10 employees
- Short description
- MediSmarts is a Nigerian health technology company that provides Medicloud, a cloud-based enterprise platform integrating HMOs, healthcare providers, and insurance enrollees for claims adjudication, pre-authorization, and health insurance operations management.
- Ownership category
- akta.pro rank
MediSmarts industry classification
Industry- NAICS
- Software Publishers (5132), Direct Health and Medical Insurance Carriers (524114), Health and Welfare Funds (525120), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (5182)
- SIC
- Hospital & Medical Service Plans (6324), Services-Prepackaged Software (7372), Services-Health Services (8000)
- akta.pro primary industry
- Revenue Cycle, Coding & Telehealth Compliance Platforms (for provider orgs) (HLALABAM)
- akta.pro secondary industries
- Virtual Care Team Collaboration & Provider-to-Provider Teleconsult Platforms (eConsults) (HLALABAI), Primary Care & General Medicine Virtual Care (Employer-Sponsored) (HLALADAA)
Keywords
Where MediSmarts is headquartered
LocationHeadquarters
- HQ city
- Suru-lere
- HQ country
- Nigeria
- HQ region
- Africa
Markets served
MediSmarts business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Infrastructure, Operations, Marketing or Sales
Revenue model
- Enterprise Software Subscriptions: Medicloud is described as an 'end-to-end enterprise solution' suggesting subscription-based licensing for HMOs and healthcare providers. The company processes ₦22 billion in claims annually, indicating transaction volume-based value capture.
- Health Insurance Operations Management: Revenue derived from providing cloud-based platform services to HMOs for managing day-to-day health insurance operations including claims processing and pre-authorization management
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Enterprise pricing for HMOs and healthcare providers |
Go-to-market motion2 records
Distribution channels2 records
Marketing channels4 records
MediSmarts product offering
Product offeringCore offering
MediSmarts sells the Medicloud cloud-based enterprise platform that manages day-to-day health insurance operations for Nigerian HMOs and healthcare providers, integrating all stakeholders through a single system. It bundles AI-powered claims adjudication, business rules, a mobile enrollee app, and APIs for external integrations, with add-on modules covering Electronic Medical Records, Telemedicine, Payment Integration, and Business Analysis.
Product overview
MediSmarts offers a platform-plus-modules architecture centered on Medicloud, a cloud-based enterprise health insurance management platform. The platform integrates all healthcare stakeholders through a modular approach, with add-on components including Electronic Medical Record (EMR), Telemedicine, Payment Integration, and Business Analysis modules. Medicloud serves as the core system handling claims automation, HMO-provider coordination, and AI-powered claims adjudication, while the complementary modules extend functionality for hospital operations management, remote patient consultations, payment processing, and financial analytics. The platform processes millions of claims annually across Nigeria's HMO ecosystem.
Differentiator
Problem solved
Functional benefit
Brands
- Medicloud: An end-to-end enterprise solution built to manage health insurance's day-to-day operations, including AI-powered automatic claims adjudication, business rules engine, and HMO portal integration.
- EMR (Electronic Medical Record)
- Telemedicine
- Payments
Quantifiable outcome
- AI-powered automatic claims adjudication reduces the time it takes to vet claims
- +3 more outcomes
Companies that use MediSmarts
Customer profileNamed customers4 records
Segments3 records
Ideal customer profiles2 records
MediSmarts technology and API
TechnologyAPI detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability3 records
Feature8 records
MediSmarts partnerships and signals
Strategic signalPartnerships
Two partnerships are on record, tiered core and minor.
- Hygeia HMOcoreHygeia HMO partnership in 2016 was the breakthrough moment for MediSmarts, transforming it from a struggling electronic medical records startup into a dominant healthtech provider. This pivotal partnership was formalized through a five-year commercial agreement and marked the company's transformation point.
- KOD StudiominorKOD Studio is credited as the design partner responsible for the company's website design, as noted in the website footer.
Scale indicators7 records
Recent moves6 records
Expansion highlights5 records
MediSmarts competitors and assessment
Company assessmentEmerging players
- Avaneer Health: Emerging payer-provider network and interoperability platform built on blockchain/Cloud. Comparable for its focus on connecting payers and providers through an integrated digital network with API-first design.
Direct peers
- HealthEdge: US-based provider of core administrative platforms (HealthRules Payor, GuidingCare) for health plans. Highly comparable as a software platform that automates claims, benefits administration, and provider collaboration for payers.
- Helium Health: Nigeria-headquartered healthtech offering EMR, hospital management, and billing software to providers and payers across West Africa. Most directly comparable as an Africa-based competitor selling modular healthcare SaaS to providers and HMOs.
- Reliance Health: Nigerian health insurance and telemedicine provider using proprietary technology to administer plans and connect members to providers. Comparable as a Nigerian payer-provider tech platform serving both HMOs and enrollees.
Broad incumbents
- Change Healthcare (Optum): Major US healthcare technology incumbent (now part of Optum) covering claims management, RCM, and payer-provider connectivity. Comparable on enterprise-scale claims automation and interoperability capabilities.
- Waystar: Large-scale revenue cycle management and claims automation platform serving hospitals and payers in the US. Comparable on AI-driven claims adjudication and provider-payer workflow automation, though at much greater scale.
- CollectiveHealth: Tech-driven employer self-funded health plan administrator combining plan management, claims, and provider navigation. Comparable business model integrating insurance operations with a digital member experience.
- Oscar Health: US health insurer operating its own proprietary technology platform for claims, provider networks, and member engagement. Comparable as a tech-led payer using digital tools for HMO-style plan administration.
Regional players
- mPharma: Ghana-based healthtech operating across multiple African countries with pharmacy, provider, and insurance-tech solutions. Comparable as an Africa-focused healthtech building integrated payer-provider software.
Others
- Health Catalyst: Healthcare data and analytics platform serving providers and payers with reporting, financial projections, and population health insights. Comparable on the business-analysis/analytics module that MediSmarts sells into HMOs.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
MediSmarts social profiles
Digital presenceMediSmarts compliance and trust
Trust signalCompliance1 record
MediSmarts financial estimates
Financial estimateRevenue estimate
Valuation estimate
MediSmarts leadership team
Management profileNumber of profiles
Profiles3 records
MediSmarts funding detail
Funding detailFunding overview
Funding rounds1 record
Investors1 record
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
MediSmarts M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about MediSmarts
What does MediSmarts do?
MediSmarts sells the Medicloud cloud-based enterprise platform that manages day-to-day health insurance operations for Nigerian HMOs and healthcare providers, integrating all stakeholders through a single system. It bundles AI-powered claims adjudication, business rules, a mobile enrollee app, and APIs for external integrations, with add-on modules covering Electronic Medical Records, Telemedicine, Payment Integration, and Business Analysis.
Is MediSmarts a public or private company?
MediSmarts is a private company. It is currently operating.
When was MediSmarts founded?
MediSmarts was founded in 2015. It employs 1 to 10 people.
Where is MediSmarts based?
MediSmarts is headquartered in Suru-lere, Nigeria, in the Africa region.
How does MediSmarts make money?
Two revenue lines are on record. Enterprise Software Subscriptions are the primary driver. The others are health Insurance Operations Management.
Who are MediSmarts's main competitors?
Avaneer Health is listed as an emerging player. Direct peers are HealthEdge, Helium Health and Reliance Health. Broad incumbents are Change Healthcare (Optum), Waystar, CollectiveHealth and Oscar Health. mPharma is listed as a regional player. Health Catalyst is listed as an others.
Does MediSmarts have an API?
Yes. Medicloud provides APIs out of the box that enable integration with external apps like CRM and Telehealth providers. Partners distribute products via API integrations to their platforms.
What industry is MediSmarts in?
Its primary akta.pro industry code is HLALABAM, Revenue Cycle, Coding & Telehealth Compliance Platforms (for provider orgs), with a secondary code of HLALABAI, Virtual Care Team Collaboration & Provider-to-Provider Teleconsult Platforms (eConsults). Its NAICS code is 5132 and its SIC code is 6324.