.png)
Who we serve > T
Be the TPA that makes independent review easy
Plans, brokers, and stop-loss partners increasingly want an independent look at the largest claims before they're paid. Highlight Health fits how you already work.
Book a CallBe the TPA that makes independent review easy
Plans, brokers, and stop-loss partners increasingly want an independent look at the largest claims before they're paid. Highlight Health fits how you already work.
Book a Call
Your clients are asking for more. You're the one who has to deliver it.
When a large claim hits a group, everyone looks to you. The plan wants answers, the broker wants options, and the stop-loss carrier wants the file.
Every RFP asks you to say yes to more: more data access, more point solutions, more flexibility, at the same administrative fee.
And every solution you add is one more thing your service team has to carry.
What you get
One more reason groups choose you
In broker RFPs and finalist meetings, supporting independent large-claim review is something most prospects have never been offered. You're the one who can say yes.
Clients who see you delivering
Reviewed claims produce outcomes your groups and their brokers can see: better numbers on the year's largest claims and a stronger stop-loss story at renewal, with your role visible at the table.
A lift your ops team won't feel
Your files, your feeds, your triggers. Claims route by criteria you and the plan set, and your team's involvement is measured in touches, not headcount. You're the TPA that already has it wired.
You're Probably Wondering
Whose work is being reviewed here?
Our review tests billed charges against the contracts, published rates, and governing requirements that determine what a claim should cost. You process claims; we examine prices.
What's the real lift on my operation?
We take your data the way you already produce it, route claims on triggers set with you and the plan, and handle the records requests, provider communication, and documentation ourselves.
What about our network contracts and turnaround guarantees?
Review runs on the plan's authorization and the plan's own rights to its claim information, inside the plan's payment window. Your network obligations stay yours; we build the workflow to comply with ERISA payment determination timing.
The plan chooses the path. We partner to deliver results.
There's more than one way to bring independent review to a group, and the right one depends on how the plan is set up and who's asking. We work with all three.
Plan-directedThe group engages us and sets the thresholds. Claims that meet them are held for review before funding.
Carrier-referredA stop-loss partner sends a claim under its own agreement with us. You supply the file; we return the result.
TPA-partneredYou make independent review part of what you offer. We set up an EDI feed with you, wire the routing, and match your data requirements.
Independent review
Whichever way it starts, every review ends the same way: a Documented Record of what the claim should cost and why, delivered to the plan, the broker, and the stop-loss carrier, with your role in the middle of it.
Make yes the easy answer
Bring one group, one claim, or your file specs. We'll show you how little it takes.