How it works

AI scaling. Rule-based precision.

We've built the first ingestion engine that combines the speed of Azure AI with the strict validation of the Benefit Plan Standard.

The Ingestion Pipeline

We don't just dump text. Our pipeline treats plan documents as data sources. We identify SBCs, EOCs, and Riders, extract their tables using Azure AI Document Intelligence, and map them to a canonical vocabulary.

Traceability is built-in: Every JSON node includes sourceRefIds that point directly to the line in the PDF where the data came from. Perfect for audit trails and dispute resolution.

Normalized Output

Forget parsing "Ded Waived" vs "No Ded". We normalize thousands of carrier quirks into a clean, typed schema:

  • Accumulators: Deductibles & MOOPs split by network tier.
  • Cost Shares: Copays, coinsurance, and logic flags.
  • Limits: Structured visit counts and frequency rules.
  • Conditions: Prior auth and referral requirements.

Key Capabilities

Built for real health plan workflows.

Our platform focuses on features that actually matter to brokers, TPAs, digital enrollment tools, and insurtech products.

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Intelligent Ingestion

Send us PDFs, Word docs, or HTML. Our classifiers automatically detect the document type and apply the correct extraction strategy using Azure AI + deterministic rules.

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Deep Normalization

One schema across every carrier. We maintain the massive library of crosswalk tables that handle the vocabulary quirks of Blue Cross, UHC, Aetna, Cigna, and more.

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Enterprise Security

Built on Azure with private storage and environment isolation. For enterprise clients, your proprietary plan documents never mingle with public data.

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Traceable Artifacts

Trust, but verify. We expose metadata paths to raw, extracted, mapped, and validation artifacts so your compliance team can audit every data point.

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Cost-Share Modeling

We structure financial data—deductibles, OOP max, and coinsurance—so you can actually run math on it. Perfect for quoting engines.

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Simple REST API

Fetch by plan ID, search by carrier/year, or filter by benefits. It's a predictable, versioned interface over a chaotic data landscape.

Roadmap

Health Plan API is designed to extend with new modules over time—pharmacy, behavioral health, dental & vision, and supplemental benefits, aligned with the Benefit Plan Standard v1.1+ roadmap.

Early customers help shape carrier priority, module scope, and quality guarantees. If you have a specific carrier or product line you need, we'd love to hear from you.

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