Healthcare cost exposure doesn’t sit with providers. It sits with organizations responsible for guiding members and paying claims. Fairfare supports platforms that sit closest to utilization decisions—giving them the ability to intervene in real time and materially reduce avoidable cost.
Solutions built for those who manage cost—without controlling care
Solutions built for those who manage cost—without controlling care
Healthcare cost exposure doesn’t sit with providers. It sits with organizations responsible for guiding members and paying claims. Fairfare supports platforms that sit closest to utilization decisions—giving them the ability to intervene in real time and materially reduce avoidable cost.
Real cost control for self-funded employers starts before the claim TPAs are responsible for administering benefits, managing claims, and supporting employers—but most cost tools activate too late. Fairfare gives TPAs a front-end cost avoidance engine that operates before claims are generated.
Real cost control for self-funded employers starts before the claim TPAs are responsible for administering benefits, managing claims, and supporting employers—but most cost tools activate too late. Fairfare gives TPAs a front-end cost avoidance engine that operates before claims are generated.
The Problem TPAs Face
Yet they typically lack:
Direct control over where members seek care
Real-time intervention tools
Visibility into avoidable utilization
TPAs are measured on:
Claims outcomes
Employer satisfaction
Cost trend management
Yet they typically lack:
Direct control over where members seek care
Real-time intervention tools
Visibility into avoidable utilization
TPAs are measured on:
Claims outcomes
Employer satisfaction
Cost trend management
The Problem TPAs Face
As a result, TPAs are left explaining costs they could not prevent.
How Fairfare Fits
Fairfare plugs into the TPA ecosystem as an AI steerage layer:
Engages members before care decisions are made
Deflects unnecessary ER visits
Routes members to appropriate, lower-cost settings
Preserves clinical integrity while reducing spend All without disrupting existing claims workflows.
Fairfare plugs into the TPA ecosystem as an AI steerage layer:
Engages members before care decisions are made
Deflects unnecessary ER visits
Routes members to appropriate, lower-cost settings
Preserves clinical integrity while reducing spend All without disrupting existing claims workflows.
How Fairfare Fits
What TPAs Gain
What TPAs Gain
Measurable reduction in avoidable utilization
Clear cost-avoidance analytics per employer
Stronger value proposition to self-funded clients
A proactive solution—not a defensive one Fairfare turns TPAs from claims administrators into cost-avoidance enablers.
Measurable reduction in avoidable utilization
Clear cost-avoidance analytics per employer
Stronger value proposition to self-funded clients
A proactive solution—not a defensive one Fairfare turns TPAs from claims administrators into cost-avoidance enablers.
Navigation without steerage is incomplete Care navigation platforms guide members—but guidance alone does not change behavior at scale. Fairfare adds real-time AI execution to navigation.
For Care Navigation Platforms
Navigation without steerage is incomplete Care navigation platforms guide members—but guidance alone does not change behavior at scale. Fairfare adds real-time AI execution to navigation.
For Care Navigation Platforms
The Problem Care Navigation Platforms Face
Most platforms:
Educate members
Provide directories and recommendations
Rely on members to act correctly under stress
But healthcare decisions are often made:
Under time pressure
Without context
With fear as the primary driver Education is not an intervention.
The Problem Care Navigation Platforms Face
Most platforms:
Educate members
Provide directories and recommendations
Rely on members to act
correctly under stress
But healthcare decisions are
often made:
Under time pressure
Without context
With fear as the primary driver Education is not an intervention.
How Fairfare Fits
How Fairfare Fits
Fairfare embeds directly into care navigation platforms via:
SDK
API
White-labeled interfaces
Our AI:
Engages members at the moment of need
Interprets symptoms and intent
Actively routes members to the right care setting
Reduces unnecessary high-cost utilization
Navigation becomes actionable, not informational.
Fairfare embeds directly into care navigation platforms via:
SDK
API
White-labeled interfaces
Our AI:
Engages members at the moment of need
Interprets symptoms and intent
Actively routes members to the right care setting
Reduces unnecessary high-cost utilization
Navigation becomes actionable, not informational.
What Care Navigation Platforms Gain
What Care Navigation Platforms Gain
Higher impact on cost outcomes
Differentiation beyond content and directories
Quantifiable ROI tied to utilization change
A true avoidance layer to complement navigation
Fairfare upgrades navigation into decision control.
Higher impact on cost outcomes
Differentiation beyond content and directories
Quantifiable ROI tied to utilization change
A true avoidance layer to complement navigation
Fairfare upgrades navigation into decision control.
Why Fairfare
Healthcare cost management fails when it reacts too late. Fairfare exists for platforms that want to change the decision – not just explain the outcome.
Why Fairfare
Healthcare cost management fails when it reacts too late.
Fairfare exists for platforms that want to
change the decision—not just explain the outcome.
Partner with Fairfare Today
Join us in transforming travel insurance for a fairer, more efficient healthcare experience.