Prepayment Integrity for Voluntary Benefits

Accuracy Before Payment

Trestl validates Hospital Indemnity, Accident, and Critical Illness claims before payment — catching overpayments, duplicates, and fraud that post-pay recovery never finds.

~4%
of voluntary claims paid in error
~$326M
estimated voluntary claims paid in error for 2026
10-12% YoY
growth with rising loss ratios

Why Trestl

Supplemental Benefits Finally Has a Prepayment Standard.

No market-standard prepayment audit layer exists for voluntary lines. The entire industry operates post-pay by default. Trestl changes that.

10-12% YoY growth

Market Scaling Fast

ACC, HIP, and CI grew 10-12% in 2023-2024. Every new policy is a new opportunity for errors to compound.

Industry gap

No Prepay Standard

No market-standard prepayment audit exists for supplemental lines. TPAs are optimized for speed, not integrity.

Shifting target

FWA Migration

As major medical detection matures, organized fraud migrates to supplemental lines where controls remain immature.

The Trestl Difference

Supplemental Specialist

HIP, ACC, and CI cert logic is native — not a plugin. Plan configurations, benefit schedules, EDF multipliers, and staging rules are first-class concepts, not afterthoughts.

Pre-Payment First

Every claim is validated before payment clears. Edits fire at the point of adjudication — not 90 days later in a recovery workflow. No chase, no write-offs.

Prospective FWA Analysis

Prepay rules catch configuration and calculation errors. Prospective analysis catches what rules can't: emerging fraud patterns, member-level schemes, and coordinated duplicates — identified before they scale.

Products

Two Lines of Defense

Prepayment integrity catches configuration and calculation errors before payment. Prospective FWA analysis catches what rules can't — before it scales.

Prepayment Integrity

Audits every claim line before payment is issued — catching calculation errors, policy violations, and duplicate submissions across Hospital Indemnity, Accident, and Critical Illness products.

What it catches

Overpayments

Claims paid above contracted amounts — rate errors, wrong benefit tiers, incorrect multipliers.

Underpayments

Members receiving less than they're owed — we flag both directions, correcting benefit ledgers and reducing provider abrasion.

Processing errors

Duplicate submissions, utilization limit breaches, waiting period violations, and diagnosis mismatches — caught before payment clears.

AI-assisted flags, built in. Accident reports are semantically compared to detect duplicate incidents. Critical Illness clinical documentation is independently reviewed by AI before payment.

Current coverageHIP · Accident · CI

Prospective FWA Analysis

Surfaces fraud, waste, and abuse that rule-based systems miss — member-level schemes, coordinated duplicates, and emerging vectors identified before they scale into material losses.

What it catches

Emerging pattern detection

Identifies coordinated schemes and trending fraud vectors across your claims population before they become material losses.

Member-level fraud targeting

Pinpoints bad actors at the member level — surgical termination that stops fraud without sacrificing the carrier-employer relationship.

Retrospective analysis

Works on historical claims data to surface patterns that only become visible over time, complementing prepayment controls.

Guaranteed findings. Share your historical claims data and we will return documented errors and FWA flags. In any meaningful claims dataset, they are there — we find them.

Current coverageAll insurance verticals

The Full Circle Effect

How Trestl Compounds Your Advantage

Prepayment accuracy creates a virtuous cycle that strengthens your market position over time.

1

Trestl Prepayment

Catch errors before they become overpayments. No recovery needed, no abrasion caused.

More money

stays with you

2

Lower Loss Ratio

Fewer overpayments = better margins

3

Competitive Rates

Price aggressively, win more RFPs

4

Better Relationships

No recovery calls, happier members

5

Market Growth

More lives = more claims to protect

Cycle repeats with compounding returns

Ready to find out?

Guaranteed findings in your claims data.

Share a historical file and we return documented errors and FWA flags before a single live claim is touched.

Request a Demo

How It Works

From Claims File to Savings in Minutes

Trestl fits into your existing claims workflow — batch file, API, or historical data file — and returns documented findings with actionable edits.

Step 1

Ingest Claims

Batch file upload, API integration, or direct TPA feed — however you move claims, we accept them.

Step 2

Validate

Every claim line runs through our validation engine and analysis. Results stream in real time.

Step 3

Review & Resolve

Flagged claims are triaged by type and severity. Your team reviews edits in our portal or your own systems.

Step 4

Return & Report

Corrected claims flow back to your adjudication system. Savings are documented and tracked.

Typical onboarding

First validators production-ready ~4 weeks after data onboarding

Analyst Review Platform

Optional

An RBAC-enabled portal that aggregates fired edits and prospective FWA flags in one place. Role-based views for analysts, managers, and carriers — each sees their scope. Alternatively, edits can be delivered directly into your payer/TPA system via API.

Claim detail & audit trail Auto-assignment by product SLA tracking API delivery alternative

Security & Compliance

Healthcare-Grade Security, Built In

Claims data demands the highest standards. Trestl is designed from the ground up for HIPAA compliance and SOC 2 readiness.

HIPAA Compliant

End-to-end PHI encryption at rest and in transit. BAA available.

SOC 2 Ready

Continuous monitoring with enterprise-grade access controls and audit logging.

Complete Audit Trail

Every data access, every edit decision, every export — logged and queryable.

Multi-Tenant Isolation

Row-level security ensures complete data separation between carriers.

Role-Based Access

Granular permissions for analysts, managers, and carrier administrators.

US Data Residency

All data stored and processed in US-based Google Cloud infrastructure.

Get Started

Request a Demo

See how Trestl can reduce payment errors and improve your loss ratio on voluntary benefit lines.

Savings analysis for your claims volume
Live walkthrough of validation and FWA detection
Implementation timeline and security review
No upfront cost — performance-based only

We respect your privacy. No spam, no sharing of your information.