Amera

Automate stop-loss claims identification, reporting, and carrier submission for self-insured employers and TPAs. AI identifies specific and aggregate eligible claims automatically. Reduce processing delays by 45% and accelerate recoveries.

Automatically convert capitation, bundled payments, and alternative payment models into standardized claims for processing. Eliminate manual exceptions with AI-powered normalization. 100% payment model coverage for TPAs and health plans.

Monitor every claim in real-time from ingestion to adjudication. Proactive alerts, performance analytics, and predictive intelligence reduce inquiry calls by 35% and prevent processing bottlenecks for health plans and TPAs.

Modern claims clearinghouse that ingests X12 837 EDI files from providers, validates data, and routes claims automatically to payers. 85%+ acceptance rates with AI-powered processing. Integration in days, not months.

Exits in the reinsurance space is placing more emphasis on disciplined pricing

Insights on claims processing automation, TPA operations, and health plan infrastructure. Expert guidance on improving auto-adjudication rates and reducing administrative costs.

Direct contracting in self-funded health plans has expanded well beyond direct primary care, covering imaging, surgery, oncology, behavioral health, and more, each solving a different cost and care problem. Building the operational infrastructure to support custom eligibility logic, claims routing, and reporting to support direct contracting takes planning to successfully execute..

Join Amera Co-founder Louise in conversation with Shawn Evans, CEO of Integrated Payor Solutions

Join Amera and help transform healthcare claims processing for health plans and TPAs. We're building AI-powered infrastructure for insurance operations. Looking for software engineers, healthcare ops, and customer success talent.

Learn how Amera Health Solutions is modernizing health plan infrastructure for TPAs. We automate claims workflows to reduce costs and enable innovative plan designs without system overhauls.

Ready to modernize your claims processing? Talk to our team about AI-powered claims routing, normalization, and stop-loss reporting. Schedule a demo or reach out to learn more.

Amera automates healthcare claims processing workflows with AI-powered solutions, reducing administrative burden for TPAs, health plans, and self-insured employers. Process, route, and manage claims with 85%+ acceptance rates.

Amera automates healthcare claims processing workflows with AI-powered solutions, reducing administrative burden for TPAs, health plans, and self-insured employers. Process, route, and manage claims with 85%+ acceptance rates.