Guides Admin Portal Guide

Admin Portal Guide

Aafiya Managed Care Platform — v1.2.0

Overview

The Admin Portal is the central administration interface for platform configuration, operational management, user administration, and AI services oversight. It is used by system administrators, operations managers, and clinical administrators. Access is restricted to users with STAFF_ADMIN or administrative roles.

Getting Started

Navigate to the Admin Portal URL and log in with your administrative credentials. The portal uses a two-panel sidebar layout: the left sidebar is organised into Configuration and Operations groups, with a top bar for global search, notifications, and profile.

Dashboard

The admin dashboard provides a high-level overview of platform health and activity including system-wide KPIs (total claims, authorisations, active cases), service health status indicators, a recent activity feed, pending review queues summary, and AI service usage metrics.

Admin Dashboard
The admin dashboard with system-wide KPIs and service health

Configuration

The Configuration section contains settings that define how the platform operates.

Platform Settings

Configure global platform parameters including organisation details (name, branding, contact information), audit log retention periods, notification default channels, SLA timeframes, and integration endpoints for external systems (MediKredit, BHF/PCNS).

Network Management

Create and manage provider network agreements, maintain the directory of registered providers, monitor network SLA compliance, and define reimbursement rates and terms per network.

Code Tables

Maintain clinical coding reference data including ICD-10, RPL (Relative Price List), CCSA (Clinical Coding Standards of South Africa), NAPPI (National Pharmaceutical Product Interface), and SAMA tariff codes. Supports add/edit/deactivate, bulk import via CSV/Excel, and version history tracking.

Code Tables
The code tables management page for clinical coding reference data

Templates

Manage communication templates (SMS, WhatsApp, email) and document templates for correspondence. All templates require approval before they become active.

Pharmacy Formulary

Manage the approved medicine list with NAPPI codes, maintain Single Exit Price (SEP), define generic substitution rules, and manage ATC risk class ratings.

Configuration Page
The platform configuration page with global settings

Operations

The Operations section provides access to all operational work queues and management interfaces:

QueueDescription
Pre-Authorisation QueueL1/L2/L3 workflow management with manual override capability
Hospital Benefit ManagementActive admissions, LOS tracking, DRG classification, benefit authorisations
Bill ReviewPending invoices, auto-approved bills, flagged reviews, appeal queue
Case ManagementActive cases, case assignment, escalation management, case closure
EMS AlertsEMS admission alerts, acknowledgement workflow, data quality review
Serious InjuriesWPI assessments, narrative reports, AMA Guide compliance verification
Medical ExpensesPast and future expense assessments, 67 baskets of care management
HPCSA TribunalProfessional conduct tribunal cases, hearings, decisions, document management
Fraud DetectionFraud dashboard, alert queue, investigation tools, flag management
Reporting & BIStandard reports, Power BI dashboards, DRG analysis, BigQuery export
Work Queues
The operations work queues overview page

User Management

Manage platform users with a searchable user list that supports adding, editing, deactivating, and reactivating user accounts.

Role-Based Access Control

RolePermissions
STAFF_ADMINFull system access, configuration, user management
STAFF_L3Senior clinical reviewer — all clinical queues
STAFF_L2Clinical reviewer — pre-auth, bill review, case management
STAFF_L1Initial reviewer — basic queue access
PROVIDERProvider portal — submit claims, view status
CLAIMANTClaimant portal — view claims, submit appeals

The audit logs section provides access to user login/activity history and configuration change logs, exportable for compliance purposes.

User Management
The user management page with role-based access control

AI Services Management

Prompt Templates

View, create, edit, and approve AI prompt templates. The platform supports version management with the ability to activate specific versions. Templates are categorised by task type: Clinical Briefing, Document Extraction, Chat, and Fraud Analysis.

Clinical Briefing

Monitor the AI clinical briefing service including briefing history, service health and latency metrics, and AI-detected anomaly flags in claims.

Document Extraction

Manage document extraction jobs with status tracking, extracted data review, failed job retry, and confidence score monitoring.

AI Services Management
The AI services management page with prompt templates and service health

Audit & Compliance

The platform maintains an immutable 7-year audit trail. All configuration changes are logged with timestamp, user, and before/after values. All operational decisions are recorded. Audit logs are stored in Cloud Firestore with append-only access and are exportable for external audit purposes. Compliance reports can be generated for Data Subject Access Requests (POPIA), and encryption status can be verified.

Audit & Compliance
The audit and compliance page with immutable trail and reports

Troubleshooting

IssueResolution
Cannot access configuration pageVerify role permissions. Contact a STAFF_ADMIN user.
Code table import failsCheck file format and column headers. Ensure no duplicate codes exist.
User cannot access a portalVerify role assignment. Check if the account is active.
AI service errorsCheck service health endpoint. Verify API keys are valid.
Audit log export timeoutLarge date ranges are processed asynchronously. Check export status.

Support

  • Email: admin-support@aafiya.app
  • Slack: #imms-operations
  • Phone: +27-XXX-XXXX
  • Escalation: Contact VP Operations for critical administrative issues