For Carriers & Payers

Regulatory-native rails between you and the beneficiary.

Eligibility, enrollment, and a compliant beneficiary experience on infrastructure built for CMS rules — not retrofitted to them.

What We Build

The problem, the answer, the product.

Clearinghouse layer

Native X12 rails

Eligibility and status checks bounce between clearinghouses, portals, and spreadsheets.

Native X12 270/271 and 276/277 over HETS-connected rails, with a single normalized event stream you can build on.

agencySHIELD + compliance gates

CMS enforcement in code

Every downstream agent interaction is a TPMO exposure you can’t see in real time.

Agent tooling with CMS disclosure, call-recording, and SOA/PTC rules enforced in code — with an append-only audit trail per interaction.

BRIDGEt beneficiary OS

Carrier-neutral enrollment surface

Beneficiary acquisition UX is fragmented and carrier-specific, so comparison and enrollment leak.

A carrier-neutral plan-compare and enrollment surface — SEP/LIS/DSNP-aware — that meets beneficiaries where they are.

Plan data layer

Schema-conformant ingestion

Onboarding a new feed or plan year is a quarter-long integration project.

Typed, schema-conformant ingestion for plan landscape, formulary, PBP, and star-ratings files, refreshed on the AEP cadence.

Compliance & Security

HIPAA-aware architecture on AWS — BAA-covered workloads, KMS CMK, PrivateLink, append-only audit at the database level.
Built around 42 CFR Part 422 — TPMO disclosure §422.2267(e)(41), call recording §422.2274, SOA/PTC §422.2264.
SOC 2 Type I targeted 2026, Type II 2027 — evidence collection running continuously today.
Security led by a HITRUST-certified CTO.

Get Started

We’ll walk your eligibility, enrollment, and compliance surface against a live architecture — no slideware.

Other ways to connect

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