NexusOps.ai
Solutions · Medical Schemes

Member AI & Benefit Navigation.

Every member gets instant, accurate benefit answers via WhatsApp — in seconds, without calling your call centre.

42% of calls to South African medical scheme call centres are benefit queries: balance checks, network provider lookups, authorisation status, benefit limits. None of these require a human agent — but they consume the majority of your call centre capacity.

Member AI handles all of these queries autonomously via WhatsApp, in plain language. Members get answers in seconds. Your call centre staff are freed for complex, high-value interactions that genuinely require human judgement.

Benefit queries

Balances, limits, network providers, authorisation status — all answered instantly

Response time

Answers in seconds — no queue, no hold music, no callback

Call centre reduction

35–50% reduction in inbound call volume within 90 days of deployment

Availability

24/7 — including weekends and public holidays

Channel
WhatsApp-native · 24/7
Deploy
Days · phased rollout available
Integrations
Rx20 · Rx30 · Proprietary systems
Compliance
POPIA · CMS · ZA residency