Silver and Lynx have launched an integrated AI claims automation solution for TPAs and other organizations administering consumer-directed benefit programs.

The integration allows organizations using Lynx to automate the review of claims for programs such as Healthcare FSA, Dependent Care FSA, HRA, Medicare Advantage supplemental benefits, and other reimbursement plans.

How the Integration Works

Many benefit claims still require participants to submit receipts, EOBs, medical statements, and other supporting documents.

Traditionally, a claim processor needs to open each document, identify the relevant information, compare it with the claim, apply the plan’s policies, and make a decision. This work can take several minutes per claim and often creates significant backlogs during peak periods.

With the new integration:

1. A participant submits a claim on the Lynx web portal.
2. The claim and its supporting documents are securely sent to Silver.
3. Silver reads the documents, extracts the relevant information, and checks against the submitted claim and applicable plan policies.
4. If all policy checks are met, Silver will automatically approve the claim. Otherwise, it will be marked for manual review.

The goal is to remove the repetitive work that prevents experienced claims teams from focusing on the cases that actually need their judgment.

AI Must Deliver Business Results

TPAs need technology that can fit into their current operations, maintain accuracy, and produce measurable ROI.

Across Silver’s TPA customers, claims are being answered approximately three times faster, while manual claim-processing tasks have been reduced by around 50%. Silver’s Claims AI is comparable to human reviews and performs at greater than 99.9% accuracy.

These results are especially important during seasonal claim spikes. Automation continues processing claims during nights, weekends, and holidays without requiring TPAs to increase staffing just to manage temporary volume.

Participants receive decisions faster, and claims teams spend less time enlarging receipts, copying information between systems, and performing the same checks repeatedly.

Built Into a Modern Benefits Platform

Lynx has built an API-first platform for TPAs and organizations looking to modernize healthcare payments and benefit administration.

By embedding Silver directly into that infrastructure, Lynx customers can add production-ready claims automation without building and maintaining their own document-processing and adjudication technology.

For Silver, this partnership creates another way for TPAs to adopt our technology as part of the platforms and workflows they already use.

Thank you to Matt Renfro and the entire Lynx team for the partnership and for sharing our focus on practical technology that improves both operations and the participant experience.

This is an important milestone for both companies, but it is also part of a larger shift we are seeing across the industry: AI is helping TPAs automate operational processes and improve the experience for customers and participants.

Read the full announcement

TPAs interested in learning how Silver can automate their claims workflows can schedule a demo.