Self-funded health benefits, run right.
SmartTPA is the modern third-party administrator for self-funded employers and their brokers: claims paid accurately in seconds, spend you can see to the dollar, and no hidden margin anywhere in the plan.
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
One health plan, working for everyone it touches.
Employers fund the plan. Brokers place it. Members use it. Providers bill it. SmartTPA is built so it works for all four.
For Employers
See every dollar in real time, lower administrative costs, and catch the claims legacy TPAs quietly overpay.
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For Brokers
Win self-funded business and keep it through renewals, with co-branded reporting and transparent compensation.
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For Providers
Real-time eligibility answers, clean claims paid in seconds, and far less phone tag with the payer.
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For Members
Clear answers about benefits, costs before care, and claims that simply work.
Learn moreWhy employers and brokers choose SmartTPA.
One platform runs the whole plan — adjudication, eligibility, portals, and compliance — instead of a patchwork of aging vendor systems. Here’s what that means for you.
Real-time spend visibility
No more month-old PDF reports. See spend, utilization, and anomalies the moment they happen — and drill into any claim.
Claims paid right the first time
Automated accuracy checks run on every claim before payment, catching the errors that quietly drain a plan.
Pharmacy without the spread
A pass-through PBM partner: the plan pays what the pharmacy is paid, rebates are visible, and we keep no pharmacy margin.
Transparent, CAA-compliant fees
One all-inclusive fee. No per-claim surcharges, no surprise invoices, and compensation disclosed on every engagement.
Onboarding without the slog
Upload your plan document and census. The platform drafts the configuration and proves it with test claims before go-live.
Built for the 2026 HIPAA Security Rule
AES-256 encryption, MFA, immutable audit logs, and 7-year retention — architectural, not bolted on.
Lower spend, without squeezing members.
Most cost-containment pitches boil down to making care harder to use. Ours comes from the plumbing — in order of reliability:
Pay the right amount, the first time
The industry mispays 5–10% of claims. Coding validation and automated edit checks run on every claim before payment — so errors are prevented, not clawed back.
Take the spread out of pharmacy
Your Rx benefit runs through an independent pass-through PBM: the plan pays what the pharmacy is paid, rebates are visible, and the PBM bills you directly.
Price care from a rational benchmark
Reference-based pricing is available as a plan design: claims priced from published Medicare-anchored benchmarks, members free to see any provider, balance-bill defense included. Prefer a traditional network? PPO network plan designs are available too.
See the savings on your own claims — before you commit to anything.
Send us a claims extract — a standard file your current TPA or carrier already produces. We run it through our pricing engine and pass-through pharmacy model, then hand you a line-by-line report of what the same claims would have cost with us.
- A standard claims file — no integration, no data migration
- Your current plan continues untouched
- Medical and pharmacy savings, itemized line by line
- Free, no obligation — walk away with the report either way
- Claims processed
- 4,218
- Mispayments caught
- 287
- Auto-adjudication rate
- 92.4%
- Average adjudication
- 1.4s
See SmartTPA in action
Find out what your current TPA is costing you.
Request a proposal — or start a free claims analysis. No integration, no risk.