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TPA Platform Integrations – Claims Intelligence API2026-05-17T12:30:39+08:00

TPA Integration

InterPixels AI Plugs Into Your Claims Stack, No Rip, No Replace, No Disruption

InterPixels AI is an API-first claims intelligence layer. It sits between your document intake and your claims management system , extracting, classifying, and returning structured data without requiring changes to your existing platform.

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Your Claims Stack

Your Existing Platform Stays. We Fit Around It.

Most integration projects fail because they demand platform migration. InterPixels does not. Your TPA system, your workflows, your adjudication logic,  untouched. We connect to what you already have and return clean, structured claim data into it. The only change your operations team notices is that documents stop requiring manual handling.

AI-Powered Data Extraction: How It Works and Why It Matters

Your Claims Documents

How Claims Documents Reach Us, Your Way

Documents enter the InterPixels pipeline through whichever channel your infrastructure already uses:

  • REST API – Send documents programmatically from your claims intake system
  • SFTP  – Drop document batches via scheduled file transfer
  • AWS S3  – Connect directly from your cloud storage bucket
  • Email Ingestion –  Forward claim document emails to a dedicated processing address
  • Webhook – Receive real-time callbacks when extraction is complete

No single method is mandatory. Most clients use one primary channel with a secondary fallback.

Interpixels Product Overview

Structured Data

How Structured Data Comes Back, Every Time

Every document processed returns a standardised JSON response. Fields are consistent across claim types , IPD, OPD, KYC , regardless of document format, language, or whether the source was handwritten, scanned, or digital. Your downstream system receives the same predictable data structure every time, ready for adjudication without manual reformatting.

Interpixels AI IDP workflow

Integration

What a Typical Integration Looks Like End-to-End

The diagram represents the standard flow. Variations exist for clients using batch SFTP versus real-time API, or those routing HITL exceptions to a validation queue before final output.

interpixels ai integration architecture TPA

Integration Journey

From Contract to Live Claims Processing, The Integration Journey

The integration scope varies by your existing infrastructure, document volumes, and internal IT capacity. InterPixels AI provides a dedicated integration engineer from kickoff through to production go-live. The stages are consistent across all clients:

  1. Document audit – We review your document types, formats, and language variations
  2. JSON schema definition – You confirm the output fields your system requires
  3. Sandbox configuration – Classification and extraction models aligned to your document set
  4. UAT and accuracy validation – Outputs tested against real claim samples
  5. Production deployment  – Live processing begins at agreed volume thresholds
Interpixels Claim Leakage in Health Insurance

Tech Team Scope

What Your Tech Team Actually Needs to Do, And What We Handle

Your team is responsible for:

  • Providing sample documents (minimum 50 per document class)
  • Confirming the JSON output schema your platform requires
  • Configuring the ingestion channel on your side (API credentials, SFTP keys, or S3 bucket access)
  • UAT sign-off before production

InterPixels handles:

  • Document classification model configuration
  • Extraction logic per your defined schema
  • HITL routing rules for low-confidence fields
  • Integration support through to go-live
  • Ongoing accuracy monitoring post-deployment
Interpixels AI Document Classifier Workflow

Security

Security, Data Residency & Compliance Considerations

Health insurance claim documents contain sensitive patient and financial data. InterPixels AI is built with this as a baseline assumption, not an afterthought.

  • Data encrypted in transit (TLS 1.2+) and at rest (AES-256)
  • APAC-region hosting available –  data does not leave your required jurisdiction
  • Token-based API authentication with role-level access controls
  • Audit trail on every document processed – timestamped, traceable
  • Data Processing Agreements available for enterprise and regulated clients

Full security documentation available on request.

InterPixels AI security complaince

INSIGHTS & INTELLIGENCE

Thinking on Claims, Documents & TPA Operations

Perspectives and analysis from the InterPixels AI team on health insurance claims automation, document intelligence, and operational efficiency across Asia-Pacific.

COMMON QUESTIONS

Frequently asked by TPA decision makers

The InterPixels AI Claims Intelligence API uses token-based authentication, where each client receives a unique API token that must be included in every request header. Role-level access controls allow different permissions to be assigned to different system users or service accounts within the same TPA organisation, so ingestion systems, validation queues, and reporting tools can each operate with only the access they require. All data in transit is encrypted using TLS 1.2 or higher, and all data at rest is encrypted using AES-256. Full security documentation is available on request, and Data Processing Agreements are provided for enterprise and regulated clients requiring formal compliance documentation before production go-live.
The InterPixels AI Claims Intelligence API returns a standardised JSON response for every document processed, with a consistent field structure across all claim types including IPD, OPD, and KYC. The response includes extracted field values, per-field confidence scores, document classification results, completeness validation status, and fraud detection flags where applicable. The schema is defined during the integration setup stage, where the TPA confirms the specific output fields their downstream claims management system requires. The same predictable data structure is returned regardless of whether the source document was handwritten, scanned, or digital, or whether it was submitted in English, Hindi, Bahasa Indonesia, or any of the other supported languages.
InterPixels AI provides a dedicated sandbox environment as part of every integration. The sandbox configuration stage begins after the JSON output schema has been defined and involves aligning the document classification and extraction models to the TPA's specific document set. UAT follows, where extraction outputs are tested against real claim samples provided by the TPA before any production traffic is introduced. A dedicated integration engineer manages the sandbox configuration and UAT process, providing accuracy reports and refining extraction logic based on UAT findings. Production deployment only begins after the TPA's technical team has completed UAT sign-off, ensuring the system performs to the agreed accuracy standard on the TPA's own document types before live claims are processed.
Yes. InterPixels AI offers APAC-region hosting for clients where data residency within a specific jurisdiction is a compliance requirement. Under this configuration, health insurance claim documents and all extracted data remain within the designated APAC region and do not transit through or reside in servers outside that jurisdiction. This is relevant for TPAs operating under data protection regulations in India, Malaysia, Singapore, Indonesia, Thailand, and the Philippines, where patient data and financial records are subject to local data sovereignty requirements. Data Processing Agreements are available for enterprise clients that require formal documentation of data handling obligations. Full details of the hosting configuration and residency options are available through the security documentation pack on request.
SFTP processing is designed for TPAs that operate scheduled batch workflows, where claim document packages are accumulated and deposited as a batch into a designated SFTP directory at fixed intervals, typically overnight or at set times during the day. The InterPixels AI pipeline monitors the SFTP location and processes batches as they arrive. REST API processing is designed for real-time or near-real-time workflows, where claim documents are submitted programmatically at the point of intake and results are returned within seconds. The choice between the two depends on the TPA's existing claims intake architecture. Most production clients use one primary channel with a secondary channel configured as a fallback, and both can be active simultaneously within the same integration.
A TPA technical team needs to prepare four things before integration begins. First, sample documents covering the claim types to be processed, with a minimum of 50 samples per document class to support model configuration. Second, confirmation of the JSON output schema, specifying which fields the downstream claims management system requires in the API response. Third, configuration of the chosen ingestion channel on the TPA side, which means generating API credentials for REST integration, providing SFTP key pairs for SFTP integration, or granting S3 bucket access for AWS integration. Fourth, availability of a technical contact to manage UAT sign-off before production. InterPixels AI provides a dedicated integration engineer who manages all other configuration, extraction logic, HITL routing rules, and accuracy validation throughout the process.
Yes. InterPixels AI maintains a full audit trail for every document processed through the claims pipeline. Each document is timestamped at ingestion, classification, extraction, and output, creating a traceable record of every processing event. The audit trail records what was received, how each document was classified, what fields were extracted, what confidence scores were assigned, which fields were routed to Human-in-the-Loop review, and what the final output contained. This level of traceability is designed to satisfy the audit and regulatory requirements that health insurance regulators across APAC impose on automated claims processing systems. The audit trail is accessible to authorised users within the TPA's account and forms part of the documentation available for regulatory review or internal compliance audits.
The time from sandbox configuration to production go-live depends on the TPA's internal UAT process and the complexity of their document set. The sandbox configuration stage, where classification and extraction models are aligned to the TPA's specific documents, typically takes one to two weeks. UAT follows, where outputs are validated against real claim samples. UAT duration depends on how quickly the TPA's technical team can review outputs, raise accuracy queries, and provide sign-off. For most clients, sandbox to production takes two to three weeks once sample documents have been provided. The overall integration journey from contract to production, including document audit, schema definition, sandbox, UAT, and deployment, typically completes within four to six weeks across all clients.
InterPixels AI supports webhook callbacks as the primary notification mechanism for asynchronous processing workflows. When a claim document package is submitted and extraction is complete, the API sends a webhook event to a configured endpoint in the TPA's system, containing the structured JSON output and processing status. This eliminates the need for the TPA system to poll the API repeatedly to check whether results are ready. The webhook payload includes the same fields, confidence scores, completeness status, and fraud flags as a synchronous response. For clients using SFTP or AWS S3 ingestion, where submissions are not tied to a synchronous request, webhooks are the standard delivery mechanism for returning structured extraction results to the TPA's downstream claims management system.
InterPixels AI provides ongoing accuracy monitoring as a standard component of every production deployment, not as an optional add-on. Post go-live, the extraction accuracy of every document class is monitored continuously against confidence score distributions and Human-in-the-Loop escalation rates. When a TPA introduces new document formats, updated templates, or new document classes not covered in the original configuration, the InterPixels AI team reviews the new samples and updates the extraction model accordingly. Changes to hospital billing formats, insurer claim form versions, or KYC document templates are treated as model maintenance events rather than requiring a new integration. The dedicated integration engineer who manages the go-live process remains the point of contact for accuracy queries and model updates throughout the production deployment.
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