Our Core Services
Our services are designed to reduce waste, eliminate friction, and enforce compliance from day one. Every line of code, policy, and workflow was built with intentionality.
Claims & Plan Administration
- Medical, dental, vision, and pharmacy claims processing
- Real-time eligibility and enrollment management
- COBRA, HIPAA, and ACA administration
- Centralized appeals and dispute handling
- Custom plan configuration aligned to ERISA standards
Cost Containment & Network Strategy
- Access to PPO and wrap networks, plus reference-based pricing
- Out-of-network repricing and direct contracting
- Provider credentialing and contract management
- Transparent pricing with validated savings
Member Engagement & Clinical Programs
- 24/7 virtual care including behavioral health
- Wellness programs with biometrics and incentives
- Integrated HSA, FSA, and HRA tracking
- Care navigation tools (partner integration coming soon)
Care Navigation & Clinical Support
Our platform identifies members who need help — then delivers it. We use AI-based risk stratification, claims data, and real clinical teams to guide better care, close gaps, and lower costs.
Network Management & OON Strategy
From TPA credentialing to OON repricing, we bring structure and visibility to what’s usually chaos. Our network approach is compliant, strategic, and built for cost containment at scale.
Plan Design & Build
Tailored plan architecture aligned with employer goals and risk strategies
Claims Adjudication
Accurate, timely claims processing powered by compliant administrative infrastructure
Compliance-First Admin
Operational execution grounded in ERISA, HIPAA, and No Surprises Act standards
API Integrations
Real-time system connectivity for eligibility, claims, and provider data exchanges
Member Navigation Tools
Digital front door and guided care navigation with benefit-specific decision support