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Simplifying
Payer Operations

Innovate, Automate, and Scale

Explore Solutions
Introducing BNi (Ben-ny): The AI-Powered Benefits1™ Assistant
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What Would You Like to Simplify Today

From benefits and provider data management to claims configuration and customer/member and provider experience, our AI-powered solutions simplify every critical aspect of payer operations.

Product and Benefits Lifecycle

Spreadsheet-based plan setup causes delays and compliance risks.

Accelerate plan design, federal and state filings, and collaboration with a smart platform that also generates CMS-compliant mandated materials.

Explore Benefits1™

Provider Lifecycle

Manual credentialing and contracts slow updates and trigger audit issues.

Streamline provider operations with intelligent workflows across roster files, credentialing, and contracts; ensure compliance with the No Surprises Act.

Explore Provider1™

Claims Configuration

Manual keying of benefits and provider data into core-admin systems causes claim errors and compliance challenges.

Use intelligent automation to configure claims systems like TriZetto® Facets® and QNXT™.

Explore Claims1™

Benefit Inquiry Experience

Slow, inconsistent responses to benefit inquiries drive up effort and reduce NPS.

Deliver smart, consistent benefit inquiry experiences across channels using AI-enhanced guidance and boost NPS.

Explore Xperience1™

Documents Management

Siloed tools delay document delivery and increase compliance risk.

Ensure on-time, AI-powered 508-compliant document (including mandated) creation, translation, and fulfillment.

Explore Simplify Docs™

Custom App Development

Manual coding of apps and workflows slows delivery and consumes resources.

Build custom apps smarter and faster with low-code and embedded AI.

Explore SimplifyX™

The Results Speak for Themselves—So Do Our Customers

Accelerated Delivery

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Speed to market
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Config time reduced
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Onboarding faster

Streamlined Operations

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Efficiency improved
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Network maintenance

Accuracy & Compliance

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Compliance boost
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Claims error

Member Experience

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NPS increase
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Call time reduced
''We were incredibly happy with the Simplify Healthcare team and their ability to think outside the box. They were super-responsive working with us to get accurate outputs, in a timely manner. We also appreciate the full transparency between our team and Team Simplify on open issues''
Associate Director Product Management & Operations
''What I appreciate about Simplify Healthcare is that they anticipate what will be needed to complete the entire project end-to-end, which minimizes late project life cycle budget increases''
Manager Benefits Implementation
''The Simplify Healthcare team took the time to understand the unique aspects of our business processes and worked with us to identify areas and opportunities where we could streamline work and utilize technology optimally''
Vice President Large Health Plan

Experience the Future of AI-Driven Healthcare Payer Operations

65+ Health Plans  partnered with us to simplify complexity, drive innovation, and modernize healthcare operations. Now it’s your turn.

Why Simplify Healthcare?

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Recognized for Market Leadership

Simplify Healthcare is positioned in the Leaders Category of the 2023 IDC MarketScape for U.S. Health Plan Product/Plan Benefit Configuration Solutions.

Read the full IDC report
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Ready to Modernize Your Group Benefits Strategy?

Learn how leading payers are gaining a competitive edge by automating group benefits at scale—powered by AI, clean data, and modular workflows.

Get the IDC Spotlight
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Enterprise Scale

A trusted partner for Payers, Simplify Healthcare has streamlined and scaled operations, delivering outstanding outcomes:
30%Operational cost reduction
300K+Providers Managed
100%Claims Compliance
9.5M+Benefit Configurations
1M+Plan Documents Generated
7.2M+Benefit Documents Processed
9+Years in Production
27ACA States
65+Health Plans
4.3M+Provider Contracts
140+Document Types
2M+Transactions Per Week

Industry Recognition