mediloop
Discuss a partnership
For TPAs and health plans

The claim is processed. The member still has a bill.

mediloop gives members a specialist for the bill that remains after adjudication: someone who reads it against the EOB, works the routes available to it, and stays with the case. Members work directly with mediloop, and the plan receives agreed aggregate reporting.

Specialist supportDirect member intakeAggregate reporting
After the claim

Member services can explain the EOB. Nobody works the bill.

A claim can process exactly as the plan intended and still leave a member with a balance they do not understand, cannot check and cannot pay in one go. That call lands with you, and it is not one your team is set up to finish.

The balance the plan did not decide

Deductible and coinsurance balances, out of network charges, and amounts left after a denial all reach the member as a provider bill, often weeks after the EOB.

The bill does not match the EOB

Duplicate lines, quantities that do not fit the visit, or a provider billing more than the EOB says the member owes. The member cannot tell which, and member services cannot call the provider for them.

The routes nobody mentions

Hospital financial assistance, prompt pay and hardship discounts, and interest free payment plans apply to the member's share, but they sit with the provider, outside anything the plan administers.

Where it sits

Outside the claim, beside your member services.

mediloop is narrow on purpose. It starts with a bill the member already has, so it sits after everything the plan does rather than inside it.

It does not touch adjudication

mediloop does not administer claims, reprice, edit claims, audit for the plan or change payment integrity. Your processes stay exactly as they are.

It complements navigation and advocacy

Where a navigation or advocacy service answers coverage and access questions, mediloop takes the specific bill in front of the member and works it with the provider. We look at any overlap during scoping.

It starts from a referral path

The lightest first step is a link or a warm handoff from member services to mediloop's intake, where the member provides their own documents and authorization.

mediloop makes no claim to reduce plan spend, premiums or stop loss exposure. The outcome it targets is what the member personally owes and the bill calls that no longer need a second or third contact.

What the member receives

Real help, from first review to resolution.

01

Understand the bill

A mediloop specialist reviews the bill alongside the EOB and supporting documents, explains what they show, and identifies the questions that need answering.

02

Find the right route

We assess appropriate next steps, which may include correcting documentation, checking how the claim was applied, exploring hospital financial assistance, arranging a payment plan, or pursuing an eligible dispute or negotiation.

03

Handle what comes next

For eligible cases, mediloop manages the follow up with the provider and keeps the member updated until the available path is complete.

Good for both sides

A route for the member. Fewer repeat calls for you.

For the member
A clear explanation of the bill against the EOB
Review for potential billing errors
Help exploring financial assistance and payment options
Support with eligible disputes and negotiations
Updates throughout the case
For the TPA or plan
Somewhere to send a bill question member services cannot close
No change to claims, eligibility or payment flows
Direct member intake and authorization
Agreed aggregate reporting on use and outcomes
A defined pilot with one group or segment first
How a member pilot works

Start with one group, not the whole book.

For a TPA that usually means one self-funded client who wants to offer it. For a plan it means one product or segment. We agree the scope with whoever owns the decision before anything is set up.

01

Agree the group and the path

Which members are eligible, which case types are supported, how member services refers people, the data boundaries, and what the plan sponsor wants to see at the end.

Scope, referral path and measures
02

Open intake

We provide the member communications and the direct intake path. Members submit their own documents and work with mediloop specialists.

Member communications and support
03

Review the outcomes

We review activation, eligible cases, charges reviewed, member responsibility before and after resolved cases, resolution time, satisfaction and repeat contacts.

Aggregate pilot report
Scope and pricing agreed before launchDirect member intake and authorizationAggregate reporting, no routine case detailNothing is provisioned before mutual fit is confirmed
Questions TPAs and plans ask

The honest answers.

No. mediloop does not administer claims, reprice, edit claims or perform payment integrity work for the plan. It works the bill the member holds after the claim has processed, with the provider, on the member's behalf.
It is narrower. Navigation generally helps members find care and answer coverage questions. mediloop works a specific bill after it arrives: checking it against the EOB, finding the assistance routes that apply, and following up with the provider. Where a plan already has a broad advocacy vendor, we look at the overlap during scoping rather than claiming there is none.
Agreed aggregate reporting about program use and outcomes. Individual case documents and medical bill details are not routinely shared, and any different reporting or data flow must be explicitly agreed and appropriately authorized.
mediloop does not make that claim. It works the member's share of the bill, not the claim the plan pays. Any direct plan savings claim would require a separately defined and measured workflow.
Not to start. A referral link or warm handoff from member services to mediloop's intake is usually enough for a pilot. Eligibility files or other data exchange depend on your requirements, so we scope them rather than promise them.
Yes, and that is often the simplest start. The pilot scope, eligibility, communications and pricing are agreed with the client and with you before launch.
Pricing is based on the eligible population, scope and agreed case allowance. We confirm the complete structure before launch. There is no published rate.
Submit the partnership form with a note about the members or client group you have in mind. We will review the fit and arrange a scoping conversation. Nothing is provisioned automatically.

All organization types · For employers · Read: the bills employees pay

Agent Loop, the mediloop fox mascot, striking a superhero pose

Tell us where the bill calls end up today.

Tell us about your organization, the members or client group you have in mind, and what happens now when a member calls about a bill they cannot understand or afford. We will review the fit and come back to you about a member pilot.

Prefer email? sales@mediloop.ai