For Platforms & TPAs
Medical, dental, vision, disability, hospital, worksite, and voluntary member services, carrier integrations, back-office processing, and discrepancy management — rebuilt as AI workflows that run inside your existing platform. Layer-first. Migration-capable. SOC 2 Type II certified, HIPAA compliant, and BAA-ready.
The Problem
Hiring through it caps margin. AI transformation is the only path that compounds.
Every plan question, eligibility check, or coverage inquiry routes through humans who navigate three or four systems to compose an answer. The cost is throughput and member experience.
Every new carrier appointment, group, or platform partner is a custom integration project. EDI feeds, file drops, and one-off APIs accumulate faster than the team can document them.
Enrollment exception handling, COBRA, premium billing reconciliation, and renewals all run on human attention. Volume scales linearly with headcount, which caps margin.
Enrollment exceptions, census-to-carrier mismatches, and premium billing deltas surface after files are sent — not before. By the time someone catches it, premium has already run.
Where We Transform
AI agents that handle medical, dental, vision, disability, hospital, worksite, and voluntary eligibility, coverage, claims status, and benefits questions inside your existing portal and CRM — with human-in-the-loop sign-off on anything sensitive.
Standardize 834 EDI, file-drop, and API integrations across medical, dental, vision, disability, hospital, worksite, and voluntary carriers — plus Employee Navigator, Ease, and benefit platforms. New partners onboard in days, not quarters.
Enrollment exception handling, COBRA processing, premium billing reconciliation, and census-to-carrier discrepancy detection — rebuilt as auditable AI flows.
SOC 2 evidence, HIPAA audit packets, and platform partner reports generated from the same source of truth — no separate cycle, no last-minute scramble.
Outcomes
From audit to production deployment
Member experience for routine inquiries
New carrier integration timeline
Compliance reporting by default
Built For Enterprise
"Platforms and TPAs win on operational density. AI transformation is how density stops being capped by headcount — and how compliance stops being a separate workflow."
SOC 2 Type II · HIPAA · BAAs with major model providers
Two weeks. One member-services, integration, or back-office workflow. A scoped architecture for what AI transformation looks like inside your platform.