Member receiving care

Reimbursement, reimagined for simplicity

No forms. No phone calls. Just fast, automated claims for gap, hospital indemnity, accident and critical illness. Eligibility is verified instantly. Payments are processed without delay.

Employers and brokers get real-time dashboards with insights into claim activity, turnaround times, and savings. Members stay informed every step of the way—with full transparency and zero paperwork.

↓ How it works

Key Features

Seamless Claim Intake Real-Time Eligibility Checks Automated Reimbursement Mobile Friendly

How It Works

Healthcare claims, simplified for all

Seamless claims intake

Accepts claims from any major health plan, integrating with carriers and TPAs for a hassle-free experience.

Carrier-agnostic processing

Works with all insurance carriers and TPAs, capturing both medical and pharmacy claims automatically.

No paperwork required

Members only provide consent and basic info once—no forms or manual uploads needed after setup.

Clear bill translation

Transforms complex EOBs into plain language, showing what’s paid, owed, and how benefits apply.

Transparent payment breakdown

Visualizes deductibles, coinsurance, and out-of-pocket max so members always know their financial responsibility.

Fast, direct reimbursement

Eligible out-of-pocket expenses are reimbursed directly to members via ACH, check, or reloadable card.

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See It In Action

Toggle between the Fixed Indemnity and Proactive Gap experience.

Faster claims. Less admin. Happier teams.

Automate intake and verification for quick payouts.
Cut HR effort with easy mobile claims.
Monitor every claim with real-time updates.
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Healthcare digital interface

Frequently Asked Questions

Answers that eliminate the guesswork

Get clear answers on how Claims Assist™ works, what’s covered, and how we support your employees.

How does the claims process work?

Once a claim is submitted, our automated system handles intake, review, and processing. If eligible, reimbursement is sent directly to the member or provider, depending on plan tier.

What types of expenses are covered?

Coverage varies by tier:
- Claims Assist™ covers routine out-of-pocket medical expenses.
- Advocate Assist™ adds bill review and negotiation.
- The full solution includes pre-payment and balance bill protection for large events.

How do members get help?

Members can reach our dedicated support team for help with claims, bill review, and provider coordination. Support is available by phone, email, or in-app chat.