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Manual processing leads to data errors and operational inefficiencies
Integration in days, not months
Claims Ingestion
Receive X12 837 EDI files, API submissions, or scanned documents from providers
Data Cleanup
Validate eligibility and provider data, correct typos, and ensure claim completeness
Smart Routing
Route clean claims to appropriate vendors and processing systems
AI Insights
Generate real-time analytics and audit trails for continuous improvement
A modern system of truth for your operations
Consolidate claims operations, cut manual work, and bolt on modern plan designs in one
unified system of record, fully observable and API-driven.
Unified Data Foundation
Single source of truth that ingests from all channels: X12 837 EDI, scanned documents, EHR data, and itemized bills.
AI Enablement Layer
Deploy AI across your operation: automated adjudication, predictive analytics, member service automation, and compliance monitoring.
Seamless Integration
Works alongside existing systems without disrupting workflows. Deploy incrementally and scale as you see results.
Medical Claims
X12 837 via SFTP,
clearinghouse, or mail
EOBs/ERAs
X12 835, mail
EHR Data
Clinical records
Itemized Bills
Pictures or member portal
integrations
Input Sources
Ingest & Parse
Validate & Enrich
Unified data layer
Data Processing
ERAs/EOBs
Claim adjudication and
processing outcome
Payment reconciliation
X12 835, mail
Customer service
Improved member support, AI
provider call deflection
Analytics & reporting
Operational insights,
compliance and plan reports
Seamless integration: works alongside existing systems without disrupting current workflows.
Data Processing
Transform your claims operation
Real results from TPAs who automated their claims routing
85%
+
Industry-leading rates through data cleanup and validation
70%
Industry-leading rates through data
cleanup and validation
60%
Fewer Carrier disputes
2-4
Contract to live claims
Real-time carrier visibility
Claims processed within seconds, not hours or days
Technical Capabilities
Enterprise-grade infrastructure designed for seamless integration with existing systems.
