The Claims Process Was Never Built for Real-Time Oversight
Employee benefit experiences are outdated and rarely used.
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Claims review happens across fragmented tools
Manual workflows slow down intervention
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Transparency data is disconnected from claims
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Scaling review requires more headcount
Analytics lag by months, not actionable in the moment
No real-time visibility into claims decisions
Site of care choices happen without employer context
Fiduciary responsibility without fiduciary-grade tools
BenOsphere helps TPAs triage and negotiate claims at scale using AI and price transparency data, while giving employers real-time visibility and measurable savings.
A Real-Time Claims Triage and Negotiation Platform
100% Claims Triage at Scale
Reviews claims for pricing issues, unbundling, upcoding, and duplicate charges.
Price Transparency Validation
Compares billed amounts against payer and hospital price data.
Focused Intervention
Only claims with real savings potential are routed for negotiation or action.
Real-Time Oversight
Employers and TPAs see claims in progress and savings impact in real time.
Give TPAs and Employers Real Control Over Claims
Operational Oversight
See claims as they move through the system, not weeks later.
Cost Exposure Clarity
Understand where spend is accumulating and where intervention matters most.
Actionable Prioritization
Focus teams on high-impact claims instead of manual sampling.
Fiduciary-Grade Decisions
Support claims decisions with defensible data and documented rationale.
Employee Benefits Realization:
The Smart Choice for Employers
Reduce up to
5%
of total medical claims spend through pre-pay triage and intervention
Triage
100%
of claims without adding analyst headcount
Deliver
5% more
claims savings for employers beyond existing TPA programs
Why BenOsphere Outshines the Rest
Capability
Real-time claim triage
AI + human intervention
Uses price transparency data
TPA-native workflowTPA-native workflow
Integrated with Slack and MS Teams
Complete stack
Simple pricing
Fast deployment (<2 weeks)
BenOsphere
Zelis
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ELAP
Artemis/Springbuk
Seamless Integration With Over 100+ HRIS/Benefits Providers test
Amplifies our ability to connect with 85% of US employers.
Meet Our AI Agents
AgencyOS powers the system. Our AI agents power the experience.
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Clara
Tracks renewals, commissions, and client metrics — helping brokers stay proactive and organized.
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Brea
Engages employees via Slack, Teams, or SMS — improving benefit literacy and reducing HR load.
Brea
Advises HR leaders on benefit design, engagement, and renewals using real-time insights.
Clara
Tracks renewals, commissions, and client metrics — helping brokers stay proactive and organized.
Brea
Engages employees via Slack, Teams, or SMS — improving benefit literacy and reducing HR load.
Brea
Advises HR leaders on benefit design, engagement, and renewals using real-time insights.
Your Questions, Answered
Still have some questions? Don’t worry. Take a look at our FAQ below.
Does this replace our TPA or existing workflows?
How is this different from post-pay audits or reports?
Is this only about price transparency?
Will this slow claim payments or member experience?
How do you prove savings and stay fiduciary-safe?
How does this support employer fiduciary responsibility?
