JetPatient Pilot · Pay on success

A 90-day evaluation for self-funded plans, with explicit success thresholds.

Run PREDICT and Guardian against your actual claims and eligibility data. We surface the high-cost surgical cohort sitting in your plan today, route the willing through our credential-verified network, and stand behind it with a contractual no-savings-no-bill guarantee. The four-page term sheet ships with this page so your fiduciary committee can review it on day one.

Length
90 or 180 days
Default 90. Quickstart for 1,000–5,000 lives.
Cost during pilot
$0 PEPM
No implementation fee. Pay-on-success only.
Time to first cohort
21 days
From executed BAA to scored top-decile members.
Exit
14-day notice
No penalty. Data exported in 30. Members in-flight finish at our expense.
Scope

What's in the pilot, what's not

Procedure scope is large enough to surface real signal, narrow enough to keep clinical safety unambiguous.

Included

  • Orthopedic — hip / knee / shoulder replacement
  • Bariatric — sleeve, bypass, revision
  • Dental — implants, full-arch, periodontal reconstruction
  • Cardiac — CABG, valve repair, ablation
  • Spine — fusion, decompression, disc replacement
  • Fertility — IVF cycles (single and multi)
  • Plastic / reconstructive — post-bariatric, post-mastectomy

Geographies: Mexico, Colombia, Costa Rica, Panama, Brazil, Thailand, Turkey, Singapore, South Korea, Spain, Czech Republic. Full network list in the term sheet.

Excluded

  • Emergency or unscheduled care
  • Active oncology in treatment
  • Pregnancy-related care
  • Any procedure requiring >48-hour return-flight medical clearance
  • Members under 18 or over 78 (case-by-case beyond)

A clinical-eligibility screen runs before every outreach. Members who don't pass are returned to the plan's incumbent network with no penalty and no record of the decline.

Success thresholds

One of four. Otherwise the pilot is free.

The pilot converts to a paid contract if any one of these is met inside the window. If none are met, JetPatient absorbs every cost and the plan owes nothing.

1
Procedure

≥ 1 case routed at ≥ 40% all-in savings

Measured vs. the plan's incumbent in-network allowed for the same procedure family.

2
Pipeline

≥ 25 top-decile members with 80% outreach completion

PREDICT identifies, Guardian outreach reaches them, even if no surgery converts inside the window.

3
Quality

Member NPS ≥ 70 · zero unresolved 90-day complications

Measured at post-discharge and again at 90 days. We hold ourselves to the higher bar.

4
Operational

First scored cohort within 21 days of BAA

Validates the integration path — eligibility ingest, claims tokenization, PREDICT scoring end-to-end.

Pricing

Free during pilot. Pay-per-case after.

No PEPM. No implementation fee. Conversion pricing is capped per case so the plan's stop-loss-leveling benefit accrues to the plan, not us.

Phase
Pricing
Notes
Pilot · 90 or 180 days
$0 PEPM · $0 implementation
Pay-on-success only. Conversion conversation begins at the threshold trigger.
Year 1 (post-pilot)
$0 PEPM · 18% of realized savings · capped at $4,500/case
Stop-loss-leveling impact passes through to the plan. We take no provider-side payment tied to referrals.
Year 2+
$0 PEPM or $2.50 PEPM bundle · 15% of savings · capped at $4,000/case
Plan elects either model. Bundle includes a named coordinator and a per-plan-tuned PREDICT.
Data & protection

Tokenized at the TPA boundary. No PHI leaves your environment in raw form.

We're plan-agnostic. We hold a HIPAA BAA with every sub-processor before any data moves.

Inputs we need

  • EDI 834 eligibility, monthly (or CSV via SFTP)
  • EDI 837 claims or de-identified extract, 36–60 months
  • Optional: PCP attribution, Rx feed, biometrics

How it's protected

  • Tokenization at the TPA boundary
  • TLS 1.3 in transit, AES-256 at rest
  • AWS us-east-1 / us-west-2; no data leaves US territory
  • BAA executed before any data exchange

If the pilot doesn't convert

  • Plan-owned data exported within 30 days
  • Sub-processor copies attested-deleted within 90 days
  • Deletion log delivered in writing
  • No marketing use of the plan name or outcomes
Take this to your committee

Three artifacts your fiduciary committee can review on day one.

The term sheet covers scope, success, pricing, data, IP, and exit on a single document. The model card and compliance attestation give your committee the safety and governance story without a sales call.

Common questions

Answers your committee will ask first

What happens if a member has a complication after the procedure?

Every routed case carries a JetPatient post-op safety net: 24×7 coordinator, in-country re-admission coverage at the original facility, telemedicine with the operating surgeon for 90 days, and a documented hand-off to the member's US primary care doctor. If a complication requires US re-admission within 90 days, JetPatient covers the difference between the plan's allowed and the actual incurred — capped at the original procedure's domestic equivalent.

How does this interact with our stop-loss carrier?

The pilot is structurally invisible to stop-loss: routed cases reduce the spec and aggregate attachment exposure (lower claims = lower utilization) but don't change contract terms. Most carriers (Sun Life, Tokio Marine HCC, Symetra, BCS, Berkshire, ELMC) have a formal medical-tourism rider; we'll provide attestation letters on request and engage your carrier directly during pilot setup if helpful.

Are dependents and spouses included?

Yes. Eligibility ingest covers the entire census including dependents. PREDICT scores the member and Guardian's outreach respects the plan's dependent-coverage rules (subscriber vs. dependent permission, age cut-offs, special-needs flags). Pediatric procedures and pregnancy-related care are excluded from the pilot.

Will this disrupt our existing TPA relationship?

No. JetPatient sits next to the TPA, not on top of it. The TPA continues to administer the plan; JetPatient receives a tokenized eligibility and claims feed and returns scored cohorts and outreach status. We've integrated with WebTPA, Trustmark, Healthcomp, EBMS, and Luminare patterns; the integration spec is on the For TPAs page.

What's the ERISA fiduciary exposure?

JetPatient holds no discretionary authority over plan administration and takes no provider-side payment tied to plan referrals. The Model Card, Validation Pack, and quarterly Fairness Audit Log are the standard artifacts a fiduciary committee can place in plan committee minutes to evidence prudent-process review under ERISA §404(a)(1)(B). An attorney-reviewed one-pager is available on request.

What if PREDICT identifies zero high-risk members in our population?

The pilot's pipeline threshold (Threshold 2) is the protection here: if PREDICT scores fewer than 25 top-decile members in your population, the pilot still meets success on Threshold 4 (operational — first scored cohort in 21 days) and we'll extend the pilot at no additional cost for an additional 90 days to gather a fuller longitudinal window.

What's the actual maturity of PREDICT?

PREDICT v0.1 is a working pipeline trained on simulated cohorts and is not approved for production use. The headline metrics (89% precision, $2.4M modeled savings, 14-month lead time) are v1.0 target spec, validated against the simulated test set. First real-world readout is targeted Q3 2026. The full Model Card explains this honestly and is downloadable above. We disclose this proactively in every term sheet.

Next step

The fastest path to a Q1 cost-trend story

Email partnerships@jetpatient.com with your plan name, covered-life count, and incumbent TPA + stop-loss carrier. A Benefits Strategist responds within one business day with a tailored MSA + BAA package and a proposed 14-day kickoff plan.