For TPAs & Administrators · Plan-agnostic by design

We sit next to your platform, not on top of it.

JetPatient is the bundled-care navigation layer your self-funded clients have been asking for. It receives a tokenized eligibility feed, returns a scored cohort plus outreach status, and routes the willing through a JCI-accredited international network. Claims still adjudicate through you. Accumulators still update through you. Your client relationship stays yours.

Integration · EDI standard

Five files in. Two files out. Standard EDI, all the way.

If your platform already produces standard X12 transactions, you produce nothing new for JetPatient. Custom CSV is supported as a fallback. SFTP and HTTPS endpoints both work; mTLS available on the sponsor's request.

EDI
Transaction
Direction
Purpose
834
Benefit enrollment & maintenance
TPA → JetPatient
Tokenized eligibility, dependents, COBRA flags, plan-tier assignment. Monthly full-file plus mid-cycle deltas.
837
Health-care claim (institutional & professional)
TPA → JetPatient
36–60 months of de-identified claims history for PREDICT scoring and savings modeling. Initial bulk; monthly incremental.
820
Premium / fee remittance
Sponsor → TPA (optional)
Per-case pay-per-success fees can flow through standard remittance lines if the sponsor prefers a single payment stream.
835
Claim payment / advice
JetPatient → TPA
For routed cases under wrap arrangement: JetPatient transmits 835 so accumulators update on the sponsor's plan ledger.
270/271
Eligibility inquiry / response
Bidirectional
Real-time member-eligibility verification at point of JetPatient outreach. Optional FHIR Patient resource endpoint as alternative.
FHIR R4
Patient · Coverage · Claim · ExplanationOfBenefit
Bidirectional
For TPAs that have stood up CMS-mandated patient-access APIs. OAuth 2.0 client-credentials flow. Smart-on-FHIR launch supported.

Full integration spec, Postman collection, and sandbox keys ship under MSA + BAA. Typical TPA integration go-live is 14–21 days from spec hand-off, including UAT.

Contract patterns

Carve-out or wrap. Your client's call.

Some sponsors want JetPatient sitting next to their existing network as a separate line item. Others want it integrated as in-network with accumulators flowing through. We support both. Most pilots start as carve-out and convert to wrap in Year 2.

Default · most common

Carve-out arrangement

JetPatient operates as a separate benefit, parallel to the sponsor's primary network.

  • Claims path: JetPatient invoices the sponsor directly per case; TPA receives an FYI 837 for reconciliation.
  • Accumulators: Member's deductible and OOP-max do credit on JetPatient procedures (the sponsor's choice — most opt in).
  • Stop-loss: Routed cases reduce both spec and aggregate exposure; carrier sees lower claims volume on the plan ledger.
  • Member ID card: Existing plan card; member calls a JetPatient coordinator number printed on the card.
  • Time to go-live: Fastest path. 21 days from BAA.
Year-2 conversion · scale model

Wrap (in-network) arrangement

JetPatient operates as a tier of the sponsor's primary network, with claims flowing through the TPA's adjudication.

  • Claims path: JetPatient transmits 835 to the TPA; TPA adjudicates against the sponsor's plan terms and accumulates normally.
  • Accumulators: Full plan-design integration. Member sees one EOB stream; no separate JetPatient ledger to reconcile.
  • Stop-loss: Routed cases appear as standard in-network claims with carve-out flag; carrier reads them as plan-design risk.
  • Member ID card: JetPatient appears as an optional preferred tier in the plan's network directory.
  • Time to go-live: 60–90 days; requires UAT cycle with the TPA's claims engine.
TPA partner roster

Already integrated, or actively scoping

Status reflects the JetPatient integration team's current state for that platform's standard transaction set. If you're a TPA not listed here, we'd like to talk.

WebTPA
Integrated
Trustmark Health
Integrated
Healthcomp
Integrated
EBMS
Integrated
Luminare Health
Integrated
BCBSA Aware
Scoping · Q3 2026
Meritain Health
Scoping · Q3 2026
UMR (UHC)
Scoping · Q4 2026
HealthEZ
Integrated
Allied Benefit Systems
Integrated
CareConnect TPA
Pilot · Q3 2026
PayerFusion
Integrated

Status legend: Integrated = standard EDI flows + sandbox tested. Scoping = integration plan signed; UAT in progress. Pilot = first live client in production.

What you get

A revenue line, not a renegotiation

JetPatient is plan-agnostic and works with any incumbent TPA. We don't replace anything you do; we add a new benefit that drives book stickiness and unlocks a new fee line for your platform.

Co-branded portal

White-labeled benefits-manager view inside Guardian, themed with your TPA's brand and rendered at your domain via reverse-proxy or iframe (your choice).

  • Your TPA name on every member touchpoint
  • Outcomes pack co-branded for client renewals
  • Logo-and-tone control in < 24 hours

Flat-fee partnership

For TPAs that bring the program to a client and operate the integration, we share a fixed percentage of the per-case success fee. Plain language in the partnership MSA, not buried in addenda.

  • 15% of per-case fee, paid quarterly
  • Honored for the full contract life of the client
  • No volume tiers, no cliffs

Book-defense story

Self-funded clients are renegotiating networks more than ever. A bundled-care benefit gives you something proactive to put in front of your client at renewal, with measurable savings to anchor the conversation.

  • Renewal-deck templates per client vertical
  • Quarterly outcomes pack auto-generated
  • Stop-loss attestation letters on demand
Data & security · TPA-grade

BAA-first. Zero raw PHI. Plan-of-record always you.

JetPatient sits inside your established data-handling perimeter, not outside it.

Identifiers tokenized at the boundary

Member identifiers are tokenized by the TPA before transmission. JetPatient never receives raw SSN, member ID, or DOB. Re-identification only happens when a member opts in to a JetPatient care pathway.

BAA chain documented

BAA executed with the TPA, the sponsor, and every JetPatient sub-processor (AWS, Snowflake, Databricks, Auth0, Datadog, SendGrid) before any data exchange. Sub-processor list ships in the Trust Center.

SOC 2 in progress · Schellman

SOC 2 Type II observation period running 2026-01-01 → 2026-09-30; first report Q4 2026. Type I available under NDA today. HITRUST gap assessment Q3 2026.

Full Compliance Attestation including HIPAA, EU AI Act readiness, ERISA fiduciary alignment, and AKS posture is downloadable on the PREDICT audit page.

Integrations team

Let's run an integration call.

30 minutes with our integrations lead, your platform team, and (if useful) one of your benefits-strategy AEs. We walk the EDI spec, show the sandbox, and answer the platform-specific questions.