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.

For Third-Party Administrators (TPAs)

For Third-Party Administrators (TPAs)

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.
 

Partner with Fairfare Today

Join us in transforming travel insurance for a fairer, more efficient healthcare experience.