This page requires JavaScript to display.
Benex — the central brain for your health plans
Live in production · 100k+ lives

{{ heroHeadline }}

Find out what's covered, what's not, and what it costs. Answers in seconds, cited to the plan documents.

SITS ON TOP OF CORE ADMIN & CLAIMS PLATFORMS.
NO MIGRATIONS NEEDED.
Coverage determination Answered in 1.4s
"Is an MRI covered?"
Confidence
High
Determination
Conditional
Covered at 80% after deductible, conditional on prior authorization. Member has $412 left on their $1,500 deductible.
Sources: ·
Instant
answers to any question
Zero
call queues
Millions
of lives, scaled without adding staff
Partners
SBMA
Beni Solutions
Breckpoint
Options Plus
SBMA
Beni Solutions
Breckpoint
Options Plus
The problem

Nobody knows what is covered until the bill arrives.

ROOT CAUSE
Plan documents are hard to surface, harder to understand, and rarely in the right hands.
01 · MEMBER
They though it was covered. The bill says otherwise.
02 · PROVIDER
Calls with coverage question. Waits on hold. Gets a maybe.
03 · OPERATIONS
Service quotes one answer. Claims decides another.
The fix is not more training
One brain. One answer. Whoever is asking.
CSR
Claims
Broker
Provider
Member
Account manager
GA
Plan admin
What a wrong answer costs
"A rep told them it was covered. We ate the claim to keep the group happy."
Every TPA has a version of this story. Benex is how you stop repeating it.
Try it, right here

Chat and voice, same brain.

Product 01
Chat — Self-Service Support
Confidence
{{ m.level }}
Determination
{{ m.det }}
{{ m.text }}
Sources:
reading plan documents…
Product 02
Voice — Call Center Staffing
Meet Riley
{{ voiceStatus }}
{{ l.who }}
{{ l.text }}
Riley is thinking…
The suite

One integration. Every surface gives the same answer.

Turn on one surface or all five. Every one you add closes another gap where a wrong answer gets out.

Coverage determinations
Ask in plain English. Get a cited determination in seconds.
Live
Claims appeals
Upload the appeal. We read it, rule on it, and draft the letter.
Live
Cost estimates
Rate files turned into estimates a member can actually read.
Live
Voice
Provider and member calls answered. Telephony included.
Rolling out
Member concierge
An app that steers members to lower-cost in-network care.
Coming soon
Pricing
Per life, per claim, per minute — or a share of what we save you.
Get a quote →
Live Transparency in Coverage

The compliance file you already publish, turned into savings.

Your rate files are public and unreadable. We turn them into estimates that steer care to the cheaper in-network option.

See it on your rate file →
MRI · hospital outpatient $1,842
Same MRI · imaging center, 3 mi $680
The plan keeps $1,162
How it works

Live in days. No migration.

We don't replace your admin platform. We read from it.

Book a walkthrough
01 Ground

Send us your plan documents. That alone runs the coverage engine — no data migration, no integration work.

02 Connect

Add eligibility, claims and rate files when you are ready. Answers get member-specific: deductible balances, denial reasons, real prices.

03 Expand

Turn on voice, appeals and concierge. No second integration.

Security

HIPAA compliant.

We process protected health information for a living. The controls come before the features.

Send us your questionnaire →
BAA in place for every customer and subprocessor.
Encrypted in transit and at rest. Full audit logging.
Every answer traces back to the plan language it came from.
Contact

Tell us what's slowing you down.

We reply within one business day, and we'll run the engine live against a real plan document on the call.

Currently supporting 100k+ lives
BAA before any data moves
No platform migration, ever
Got it. We'll be in touch within one business day.
Source document
{{ docTitle }}
{{ docTitle }}
{{ b.label }}

{{ b.text }}
{{ docMeta }}
Highlighted language is what the answer was grounded in.