Most calls to a payer exist because the system could not answer in writing.
When a plan runs on SmartTPA, eligibility answers in real time before the visit, clean claims adjudicate in seconds, and the remittance explains itself. Your team stops calling because the answer is already there.
- 2026 HIPAA Security RuleBuilt to it, not retrofitted
- AES-256 encryptionAt rest and in transit
- Immutable audit logs7-year retention
- SOC 2 Type IIIn progress, and we say so
- Clearinghouse-ready EDIClaims in, remittances out
What changes for you
Less friction on every claim, from eligibility to payment.
You do not choose the plan’s administrator. The employer does. But when that administrator is SmartTPA, the work on your side gets measurably lighter. Here is how a claim moves through the platform.
Eligibility before the visit, not after
Run 270/271 in real time and know what the plan covers while the patient is still at the desk. No hold music, no callback tomorrow, and no discovering three weeks later that coverage had terminated.
Clean claims clear in seconds
Submit an 837 and clean claims adjudicate in under two seconds. They do not sit in a manual queue waiting for someone to reach them, because there is no manual queue for claims that have nothing wrong with them.
Remittance you can read the first time
835s arrive with CARC and RARC codes plus the plain-language reason. When a line is adjusted you can see why without opening a ticket, which removes most of the reason anyone would call.
Payment you can forecast
Clean claims pay promptly on a schedule you can plan around. Your cash flow stops depending on how backed up somebody else's queue is this month.
Fewer denials to rework
Validation catches coding and coverage problems up front, so the claim comes back correctable rather than denied. Rework is the most expensive thing a billing team does and most of it is avoidable.
A portal, and a person when you need one
Eligibility, claim status, and remittance in one place. When the portal cannot resolve it, you reach someone who can see the same claim you are looking at.
A claim that pays cleanly is a patient who used their benefits.
If you are an employer or a broker tired of an administrator that buries providers in friction and then wonders why members avoid care, that is the problem we set out to fix.
For providers and billing teams
See how a claim actually moves.
Walk through eligibility, adjudication, and remittance on the platform, or reach us with a question about a SmartTPA-administered plan.