Self-funded administration runs on basis points. Lumiknox lifts your first-pass adjudication rate, hardens your stop-loss data integrity, and provides surge capacity around plan-year transitions and renewals.
Self-funded TPAs, ASO administrators, taft-hartley fund administrators, multi-employer welfare arrangements.
Whether you’re running one line of business or all of them, our pods configure to your platform, your accreditation calendar, and your commercial model. We don’t force you onto our process — we embed inside yours.
Most TPAs sit 6–12 points below their platform’s theoretical max. Our edit-resolution agents close that gap.
Medicare crossover, dependent verification, working-aged rules — small errors, big leakage. We audit and remediate.
Reinsurance carriers are getting strict. Catastrophic claim reporting needs to be clean the first time.
Q4 and Q1 spike volumes 3–5x. We embed claims processors and customer service reps on a flexible footprint.
Lumiknox claims AI is built for TPAs and self-funded plan administrators who need to lift first-pass adjudication rates without inviting lea…
ExploreSolution 05 · BillingLumiknox agents triage rejections, work denials, post payments, and reconcile cash — under supervision from a human Ops Lead. Built for hosp…
ExploreSolution 07 · IntelligenceOur applied-AI team builds, trains, and operates predictive models that live inside your operations — HCC recapture propensity, member lapse…
ExploreSolution 01 · CodingInpatient, outpatient, profee, and HCC coding by AHIMA- and AAPC-credentialed coders. Concurrent or retrospective. Onshore-supervised, with …
Explore