Mental Health Cover is easy to sell and hard to service. Heyrafiki gives you the network, the clean Claims and the outcomes to service it well, so it becomes Cover Members renew for, not a Helpline they forget.
Verified Practitioners in, clean coded Claims out, every one adjudicated and fraud-checked before a shilling is approved.
Licence verified, cover confirmed, codes validated and fraud-checked before approval. Claims arrive clean and adjudicated, so almost none bounce back for rework.
Every Practitioner is verified against the Official Records before their first Session, and re-checked on a standing schedule.
Dr. A. Wanjiru
Clinical Psychologist · Nairobi
Standards-based data from every Session turns Mental Healthcare from an unpriceable risk into a product you can build.
A Helpline number in a booklet is not a Mental Health Benefit, and Members know it. Heyrafiki gives you the real thing: prevention, Therapy and Crisis Support on one Rail, settling into the Schemes you already run.
Every Practitioner under the Heyrafiki Umbrella is licence-verified and credentialed before a single Claim reaches you. You contract one Virtual Facility and receive an entire verified network.
Mental Health Claims have been expensive to verify and easy to doubt. These are the rails that change the economics: verification before settlement, structure at the source and Care matched to clinical need.
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Credentialing you never have to repeat.
Every Practitioner under the Heyrafiki Umbrella is licence-verified against the Official Records before their first Session, and re-checked on a standing schedule. You onboard one Virtual Facility and receive the whole verified network behind it.
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Structured at the source, checked before money moves.
Codes attach the moment the Practitioner approves the SOAP Note, not weeks later from a paper receipt. Before settlement, every Claim is machine-checked: the Licence, the Cover, the codes and the record that the Session took place.
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Stepped Care keeps Claims honest to clinical need.
Matching routes mild needs to Counselling and guided Self-Care, and reserves specialist Care for the cases that need it. Claim costs start reflecting clinical need, and early Screening reaches Members before a manageable concern becomes an acute one.
Guided Self-Care
most Members
Counselling
when it helps more
Specialist Care
when clinically needed
Cover your Members use, and numbers you can stand behind at renewal.
Proactive tools, Therapy, Crisis Support and Insight under one Facility contract.
Structured, coded and consistent, straight from the Session.
Checks live on the rails, not bolted on after the money moves.
Lightweight integration into the Benefits you already underwrite.
Utilization, adherence and recovery signals, in aggregate, never identities.
Members who can book Care straight from their Cover feel its value at every renewal conversation.
What changes when Claims are born structured instead of reconstructed.
| Legacy Panels |  On Heyrafiki | |
|---|---|---|
| Practitioner onboarding | Manual credentialing, facility by facility | One network, licence-verified continuously |
| Claim format | Paper receipts and scans | Structured, coded, consistent |
| Fraud posture | Investigated after payment | Machine-checked before settlement |
| Reporting | Monthly extracts | Live aggregate dashboards |
| Member experience | A helpline printed in a booklet | Cover Members book with, in the app |
Light. Heyrafiki bills as one Virtual Facility, so onboarding looks like adding a single Facility to your panel, with structured Claims from day one. Deeper API integration into your Claims systems is available when you want it.
Every Claim is machine-checked before settlement: the Practitioner's licence and standing, the Member's Cover, the codes, and the booking and attendance record behind the Session. Unusual patterns go to human review before money moves.
Aggregate, privacy-preserving reporting: utilization, adherence and outcome signals across your covered population. Identities and Session Content are never part of it, so you price risk on clean data without carrying the privacy exposure.
They see it inside the product: Cover found and applied before Payment, verified Practitioners they can book directly, and no reimbursement paperwork.
Yes. Every Claim carries its own audit trail: the booking, the attendance record, the SOAP Note approval behind it and the settlement event. An auditor traces any Claim end to end without ever touching clinical content.
Mental healthcare carries a $15B financing gap. The Insurers who move first will set the standard everyone else follows.
