Nigeria Healthcare Claims Management Market Report 2022 to 2030

Nigeria Healthcare Claims Management Market Analysis

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The Nigeria healthcare claims management market is projected to grow from $24.03 Mn in 2022 to $137.82 Mn by 2030, registering a CAGR of 24.4% during the forecast period of 2022 - 2030. The main factors driving the growth would be increasing healthcare expenditure, adoption of digital technologies, government initiatives and growing health insurance coverage. The market is segmented by component, type, by delivery mode and end-user. Some of the major players include AXA Mansard Health, Octamile, Curacel, AXA, Cigna and Allianz.

ID: IN10NGHS006 CATEGORY: Healthcare Services GEOGRAPHY: Nigeria AUTHOR: Neha Davda

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Nigeria Healthcare Claims Management Market Executive Summary

Nigeria's market for healthcare claim management is expanding quickly as a result of the country's rising need for good and affordable healthcare services. Nigeria, which has a population of over 200 million, has a sizable market for healthcare services, and the government is working to raise the quality of healthcare delivery there through a number of different projects.

Private health insurance providers dominate the healthcare claim management business in Nigeria, accounting for a sizable portion of the market. These businesses offer people and businesses a variety of health insurance plans that cover a variety of healthcare services, such as doctor visits, lab work, and hospitalisation. The Nigerian government has also started a number of initiatives to increase the effectiveness of healthcare claim management in the nation, in addition to private health insurance firms. For instance, the National Health Insurance Scheme (NHIS) is a government-run health insurance program that offers low-income individuals and vulnerable groups in the nation access to cheap healthcare services.

Nigeria Healthcare Claims Management Market

Market Dynamics

Market Growth Drivers

The Nigeria healthcare claims management market is expected to be driven by factors such as:

Increasing healthcare expenditure- In recent years, the Nigerian government has raised the amount it spends on healthcare, which has encouraged the construction of new institutions and the expansion of already existing ones. As a result, there is a significant increase in the need for healthcare claim management services
Adoption of digital technologies- The expansion of the healthcare claim management market in Nigeria is also being fueled by the deployment of digital technologies like EHRs and telemedicine. These technologies have simplified patient data management and patient communication for healthcare professionals, improving patient outcomes and boosting efficiency
Government initiatives- The Nigerian government has started a number of projects to raise the level of healthcare service in the nation. As more individuals look for inexpensive and effective healthcare services, efforts like the National Health Insurance Scheme (NHIS) have increased demand for healthcare claim management services
Growing health insurance coverage- The demand for healthcare claim management services has increased as more people in Nigeria are now covered by health insurance. A variety of healthcare services are included in the affordable, comprehensive healthcare plans that health insurance firms are increasingly offering

Market Restraints

The following factors are expected to limit the growth of the healthcare claims management market in Nigeria:

Inadequate healthcare infrastructure- Despite government efforts to upgrade Nigeria's healthcare infrastructure, the nation still suffers from a severe lack of healthcare services, especially in rural areas. Due to a potential shortage of healthcare professionals to deliver services to patients, this lack of infrastructure may be able to restrain the growth of the healthcare claim management market
Low healthcare literacy- Many Nigerians still lack a thorough understanding of healthcare and health insurance. This may make it challenging for healthcare providers and insurance firms to convey the value of healthcare services and the necessity of health insurance, which may restrain the market's ability to grow for healthcare claim management
Fragmented healthcare system- Many healthcare providers in Nigeria operate independently of one another, creating a highly fragmented healthcare system. As a result, it may be challenging to coordinate healthcare services and handle healthcare claims, which may restrain the market's expansion for healthcare claim management

Competitive Landscape

Key Players

AXA Mansard Health (NGA)- is dedicated to providing customers with a quality claims experience both during and after the loss. To help their clients quickly handle their day-to-day operations and resume their activities, they offer a coordinated approach to claims management that adopts effective claims-processing methods
Octamile (NGA)- allow insurance and non-insurance companies to streamline insurance access and shield Africans from financial loss. With its ClaimsTech technology, insurers can quickly process payouts in under an hour while assisting in the detection of fraud. Via its integrated insurance API, B2C enterprises can sell insurance as a standalone product or as an add-on to their current offerings on digital platforms or mobile apps. They safeguard their customers while producing a new source of income
Curacel (NGA)- Curacel, a Nigerian startup, is assisting African insurance businesses by facilitating rapid claims administration and correct payouts. However, it began in the e-health sector. The insurance claims process is automated using Curacel, enabling personnel to process large numbers of claims swiftly and effectively. Curacel also automatically screens claims for fraud, waste, and abuse
Cigna- a global provider of healthcare services, provides health insurance and related services. Provider network management, customer assistance, and claims processing are just a few of the healthcare claims management services offered by the company
Allianz- is the one-stop shop for all of your life and health insurance needs. Alternatives are provided for short-term or emergency protection, critical sickness, life and disability insurance, and international health insurance

Notable Deals

March 2022: With the help of a business alliance with AXA Mansard, the East African company Turaco has declared its entry into Nigeria. The partnership between AXA and Turaco will enable them to increase the distribution of AXA 's all-inclusive insurance solutions.

1. Executive Summary
1.1 Service Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Healthcare Services Market in Country
1.6 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Market Size (With Excel and Methodology)
2.2 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company
4.2.1.1 Overview
4.2.1.2 Product Applications and Services
4.2.1.3 Recent Developments
4.2.1.4 Partnerships Ecosystem
4.2.1.5 Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Services
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Healthcare Claims Management Market Segmentation

By Component (Revenue, USD Billion):

Further breakdown of the software and services segment of the healthcare claims management market

Software
Services

By Type (Revenue, USD Billion):

Although they have nothing to do with it, skills unrelated to patient care are equally crucial for any healthcare organization that wants to stay in business. Among these are managing intricate insurance regulations, comprehending best practices for data collection, and analyzing data to identify areas for development. For the above reasons, providers are constantly looking for methods to improve claim administration and medical billing systems. Setting up an integrated billing and claims processing system is one approach to accomplish this, which has a number of benefits.

Integrated Solutions
Standalone Solutions

By Delivery Mode (Revenue, USD Billion):

On-Premise
Cloud-Based

By End User (Revenue, USD Billion):

Healthcare Payers
Healthcare Providers
Other End Users

Healthcare payers in this market are anticipated to rise quickly over the course of the projection period because of the installation of strict regulatory requirements, a lack of experienced personnel internally for claims processing, rising healthcare expenditures, and fraud associated with those charges. Payers have also assisted healthcare providers by creating a web-based and cloud-based interface that helps them manage medical billing and associated claims and offers accurate and timely information about the epidemic.

Methodology for Database Creation

Our database offers a comprehensive list of healthcare centers, meticulously curated to provide detailed information on a wide range of specialties and services. It includes top-tier hospitals, clinics, and diagnostic facilities across 30 countries and 24 specialties, ensuring users can find the healthcare services they need.

Additionally, we provide a comprehensive list of Key Opinion Leaders (KOLs) based on your requirements. Our curated list captures various crucial aspects of the KOLs, offering more than just general information. Whether you're looking to boost brand awareness, drive engagement, or launch a new product, our extensive list of KOLs ensures you have the right experts by your side. Covering 30 countries and 36 specialties, our database guarantees access to the best KOLs in the healthcare industry, supporting strategic decisions and enhancing your initiatives.

How Do We Get It?

Our database is created and maintained through a combination of secondary and primary research methodologies.

1. Secondary Research

With many years of experience in the healthcare field, we have our own rich proprietary data from various past projects. This historical data serves as the foundation for our database. Our continuous process of gathering data involves:

Analyzing historical proprietary data collected from multiple projects.
Regularly updating our existing data sets with new findings and trends.
Ensuring data consistency and accuracy through rigorous validation processes.

With extensive experience in the field, we have developed a proprietary GenAI-based technology that is uniquely tailored to our organization. This advanced technology enables us to scan a wide array of relevant information sources across the internet. Our data-gathering process includes:

Searching through academic conferences, published research, citations, and social media platforms
Collecting and compiling diverse data to build a comprehensive and detailed database
Continuously updating our database with new information to ensure its relevance and accuracy

2. Primary Research

To complement and validate our secondary data, we engage in primary research through local tie-ups and partnerships. This process involves:

Collaborating with local healthcare providers, hospitals, and clinics to gather real-time data.
Conducting surveys, interviews, and field studies to collect fresh data directly from the source.
Continuously refreshing our database to ensure that the information remains current and reliable.
Validating secondary data through cross-referencing with primary data to ensure accuracy and relevance.

Combining Secondary and Primary Research

By integrating both secondary and primary research methodologies, we ensure that our database is comprehensive, accurate, and up-to-date. The combined process involves:

Merging historical data from secondary research with real-time data from primary research.
Conducting thorough data validation and cleansing to remove inconsistencies and errors.
Organizing data into a structured format that is easily accessible and usable for various applications.
Continuously monitoring and updating the database to reflect the latest developments and trends in the healthcare field.

Through this meticulous process, we create a final database tailored to each region and domain within the healthcare industry. This approach ensures that our clients receive reliable and relevant data, empowering them to make informed decisions and drive innovation in their respective fields.