Know what care costs before you go, not when the bill arrives.
If your employer’s plan runs on SmartTPA, your claims, your EOBs, your ID card, and where your deductible stands are all in one place. Every line is written to be read once. When the portal cannot answer something, one email address reaches the people who administer your plan.
- 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 you get
Straight answers about your own coverage.
You did not choose your plan’s administrator. Your employer did. But when that administrator is SmartTPA, the parts of health coverage that normally cost you an afternoon on the phone are things you can look up yourself in a minute. Here is how a claim moves through the platform.
Every EOB line explains itself
An explanation of benefits usually reads like paperwork written for somebody else. Yours shows what the provider billed, what the plan paid, what is left for you, and the reason for each line in language you do not have to decode.
Where your deductible stands, right now
Deductible and out-of-pocket totals update as claims finish processing. You can see what is left before you schedule care instead of finding out when the bill shows up.
An estimate before the care, not a bill after it
Look up what a procedure is likely to cost under your plan while you are still deciding. Knowing the number in advance is the difference between choosing care and bracing for it.
Your ID card lives on your phone
Pull it up in the portal or the app and add it to your phone's wallet. Nobody should have to wait on mail to fill a prescription.
Questions answered against your own plan
Ask what is covered and get an answer grounded in your employer's plan document and your own claim history rather than a generic FAQ. Anything that needs a person goes to one.
Your family in one view
Dependents, coverage dates, and the claims filed under each of them, without a separate login for every person on the plan.
If something is wrong
A claim, an EOB, or an appeal. Here is exactly what to do.
Every one of these ends somewhere you can actually get to today: the portal, or the support inbox. Nothing here requires you to sit in a phone queue to find out who owns your problem.
About a claim
Providers send most claims to us electronically, so usually there is nothing for you to do. Sign in and open Claims to see where one stands and what it is waiting on. If a claim you expected is still missing a couple of weeks after the visit, that generally means the provider has not sent it yet. Email us the date of service and the provider's name and we will go find it.
About an EOB
An EOB is not a bill. It is the record of how your plan handled a claim, and it arrives before or alongside whatever the provider sends you. Open EOBs in the portal to read each line. If a provider's bill asks you for more than the EOB says you owe, send us both documents before you pay anything.
About an appeal
If a claim is denied, or paid for less than you expected, the EOB carries the reason and the deadline to appeal. Start one through the portal or by emailing [email protected], and attach anything your provider gave you. An appeal is decided by someone who had no part in the original decision, and a clinical question goes to an independent reviewer outside SmartTPA.
How to reach member support
Email is how we take member questions, including a problem with a claim and the start of an appeal. Write from the address on your account where you can, and include your plan or the name of your employer so we can find you quickly. Please do not include a Social Security number.
[email protected]Already signed up? Most answers are faster in the member portal, which can see your claims and your accumulators while an email cannot.
The app, on Android
The SmartTPA member app carries your ID card, your claims, and your EOBs, and it locks behind your device biometrics. An iPhone version is not out yet. Until it is, the portal works in any mobile browser and the ID card adds to your phone wallet from there.
Get it on Google PlaySigning in needs an account on a plan SmartTPA administers. If your employer has not moved yet, the app has nothing to show you.
Members never get a vote on who administers the plan.
The people who do are your HR or benefits team and the broker who advises them. If that is you, the same record that lets a member see exactly why a claim paid the way it did is what an employer gets at renewal.
For plan members
Sign in, or just email us.
The portal holds your claims, EOBs, ID card, and deductible status. Anything it cannot answer goes to [email protected] and reaches a person.