We’re rebuilding health plan administration from the ground up.
The TPA industry runs on 20-year-old software, manual processes, and pricing nobody can explain. SmartTPA replaces all three: a claims platform built this decade, and plan economics with no hidden margin in them.
Built to meet the strictest healthcare standards
- HIPAA Aligned2026 Security Rule
- Security-First ArchitectureSOC 2 in progress
- AES-256 EncryptionAt rest & in transit
- Immutable Audit Logs7-year retention
- Clearinghouse-Ready EDIClaims in, remittances out
Make world-class claims processing accessible to every employer.
Large carriers spend hundreds of millions on proprietary adjudication systems. Small and mid-size self-funded employers are stuck with legacy platforms that are slow, opaque, and failing to keep up with modern compliance requirements.
SmartTPA levels the playing field. Our platform delivers enterprise-grade auto-adjudication, real-time eligibility, and full EDI pipeline support — without vendor lock-in.
We’re not just building software. We’re building administration self-funded employers and their brokers can rely on — the speed, accuracy, and transparency the biggest carriers guard for themselves, put in the hands of everyone they’ve left behind.
By the numbers
What drives every decision we make.
Compliance First
Every architectural decision starts with HIPAA. We don’t bolt on security — we build on it. AES-256, TLS 1.2+, MFA, immutable audit logs. No exceptions.
Radical Transparency
Transparent fee structure, open pilot terms, and a published list of every subprocessor that touches your data. Nothing to hide, nothing buried in an appendix.
Speed as a Feature
Sub-2-second adjudication isn’t a benchmark — it’s a promise. Every millisecond of latency in claims processing costs real money.
No Lock-In, Ever
Documented APIs, standard data formats, and full export whenever you ask. If we stop earning your business, your data leaves with you.
Member-Centric
Behind every claim is a person waiting for care. Faster adjudication means faster payments, fewer denials, and better health outcomes.
Built for 2026
The 2026 HIPAA Security Rule eliminates addressable safeguards. We’re not catching up — we started here.
A TPA platform for the next 20 years — not the last 20.
We started SmartTPA because the existing options for self-funded employer health plans are broken. Legacy TPA software was written before the cloud existed. Most TPAs still process claims manually, with error rates hovering between 5% and 10%. Employers can’t see where their dollars go. Members wait weeks for claim resolution. Compliance is an afterthought.
The 2026 HIPAA Security Rule raises the bar again: every safeguard is now mandatory. Platforms designed before the cloud will spend years retrofitting controls, and the cost of that retrofit will land on employers and members. We started from the current rule instead of migrating toward it.
SmartTPA is that rebuild. The platform is compliance-first, transparent by design, and uses AI where it produces results conventional rules-based systems cannot: auto-adjudication, document intelligence, and the member concierge chat. Everything a modern self-funded employer needs, in a single system.
We're also deliberate about what we don't build. Pharmacy runs through an independent pass-through PBM. Reference-based pricing, utilization review, and external appeals run through established, independent partners — each chosen for transparency, each kept structurally separate so no one grades their own work. We take no hidden margin from any of them; our administrative fee is the whole of what we earn.
- Zero tolerance for hidden fees
- Every claim, every decision, logged immutably
- AI that augments humans, not replaces accountability
- Built for small and mid-size plans the industry ignores
See SmartTPA in action
Want to see it in action?
Explore the interactive demo, or request a tailored proposal for your group.