Runtime infrastructure · TPA claims

The Claims OS.

Every claim. Every workflow. One runtime.

Indian TPAs run on document chaos, manual review queues, and email queries. Slate Labs is the operating system layer underneath. Agents read, reason, and route every claim through pre-auth, enhancement, discharge, and FWA, while your reviewers own every decision.

RUNTIMEPersistent agent processes across all claim workflows.
CONTROL PLANEReviewers approve. Agents never decide alone.
AUDIT LEDGEREvery output carries the evidence trail.
[SYS:TAT]30–50%review time reduction per packet
[SYS:OPS]20–40%fewer avoidable hospital queries
[SYS:CAP]1.5–2×reviewer throughput multiplier
[SYS:AUD]100%claims with traceable evidence

The TPA reality

Your reviewers are buried in PDFs. AI agents can carry the load.

A typical TPA processes thousands of pre-auth requests, enhancements, and discharges every day. Most of that work is still manual: opening documents, reading discharge summaries, comparing line items against policy terms, drafting queries, chasing missing paperwork. We hand the repetitive, rules-heavy reasoning to specialised AI agents so your humans focus on the judgement calls only they should make.

01

Document chaos

Pre-auth forms, ICPs, bills, prescriptions, investigation reports, and discharge summaries arrive in inconsistent formats from hundreds of hospitals. No two packets look the same. Reviewers spend 40% of their day just locating the right file.

02

Pre-auth and discharge TAT

Manual review queues stretch turnaround time for hospitals and members, trigger SLA breaches with insurer clients, and compound during peak claim periods when volumes spike without warning.

03

Repetitive queries

The same missing-document and clarification queries get drafted from scratch, claim after claim, day after day. Every query that goes out without a cited reason invites a back-and-forth that delays the entire packet.

04

Weak audit trails

Decisions scatter across emails, portals, and PDFs. Reconstructing why a claim was approved, queried, or denied takes hours, and in dispute or audit scenarios, those hours become days.

Runtime processes

Six processes. One operating system.

The Claims OS runs six persistent agent processes, each owning a defined stage of the claims lifecycle. They don't help your team. They run the workflow. Your reviewers are the control plane.

PROC-01 Autonomous

Intake & Extraction Agent

Reads pre-auth forms, ICPs, bills, prescriptions, investigations, discharge summaries, and policies. Classifies, extracts, and links clinical, billing, and policy entities into a structured claim record.

Tools: OCR · document classifier · entity linker

PROC-02 Reasoning

Pre-Authorization Agent

Checks completeness, summarizes diagnosis and planned treatment, validates eligibility against policy terms, and prepares a one-screen reviewer packet with citations to source pages.

Tools: policy retriever · clinical summarizer · eligibility checker

PROC-03 Reasoning

Discharge Authorization Agent

Reconciles final bills, discharge summaries, package rules, and policy terms. Surfaces non-payable items, duplicates, and ineligible charges with the supporting clause cited.

Tools: tariff matcher · clause linker · bill reconciler

PROC-04 Action-taking

Query Drafting Agent

Drafts structured queries to hospitals, members, or internal teams with evidence and missing-document context attached. Reviewer reviews and sends, never starts from a blank screen.

Tools: template library · evidence assembler · channel router

PROC-05 Investigative

FWA Signals Agent

Detects duplicate claims, suspicious billing patterns, unusual provider behaviour, and policy inconsistencies. Hands investigators a packet with the supporting evidence already pulled together.

Tools: similarity index · provider profiler · pattern miner

PROC-06 Interop

NHCX Interop Agent

Shapes structured, interoperable claim data from messy documents to support NHCX-aligned exchange with insurer and hospital partners. FHIR-shaped where it matters.

Tools: FHIR mapper · schema validator · insurer adapters

See how each agent works

How we build

Three principles. No exceptions.

01

Agents own the workflow, not just parts of it.

Each TPA workflow has one named agent process with defined inputs, defined tools, and a defined output. There are no black boxes. If an agent cannot cite its source, the output does not ship.

02

Reasoning over rules, because real claims are messy.

Hard-coded rules engines break on the edge cases that make up a third of every claims queue. Our agents combine retrieval, structured reasoning, and policy grounding to handle the claims that rules cannot.

03

Humans approve. Always. No exceptions.

Agents prepare, structure, and recommend. Your licensed reviewers approve. Every action the OS takes is logged, auditable, and reversible. We do not want to replace your reviewers. We want to make each one do the work of three.

Pilot

Proof of runtime in 6 weeks. On your own claim files.

We run the Claims OS against your historical claims, 500 to 5,000 files. Your reviewers work the dashboard. After 6 weeks you have measured outcomes, not a slide deck.

Read the pilot brief

Indian TPAs handling 50,000+ claims a year. If that's you, let's talk.

Request a runtime demo