Magic Health for TPAs & Insurance
Simplify Complexity. Build Confidence. Improve Star Ratings.
From fragmented interactions to clarity, from trust to whole-person health.
From conversations about access to care, to clarifying benefits, to ensuring accurate claims adjudications—we bring it all together into one seamless experience.
The Challenge
Every day, TPAs and insurance providers strive to do the right thing for their members. Yet the sheer volume and complexity of healthcare often overwhelms even the best efforts.
Members call with questions about benefits, in network providers, claims, bills, or coverage limits. Too often, they leave without clear answers. Providers push back on denials. Subtle cues that suggest a member may benefit from case management are often buried in routine calls. Persistent challenges can drive staff burnout and churn—highlighting the need for solutions that support both employees and organizational stability.
Our Solutions
Magic Health simplifies complexity by turning every call, chat, and message into actionable insights. It guides follow-ups, strengthens conversations, and ensures no member concern goes unnoticed.
Claims & Coverage Confusion
EOB clarifications, understanding member liability, and reducing friction from high deductibles or processing errors.
Benefits & Access to Care Clarifications
Clarify physician selection, coverage rules, and options to minimize out-of-pocket expenses.
Case Management Triggers
Detect conversational cues that signal chronic conditions or high-risk needs requiring intervention.
Communication Breakdowns
Identify inconsistent responses and unclear benefit explanations that erode trust.
Agents get real-time coaching to respond with clarity and empathy. Leaders see performance dashboards that track trends across groups and pinpoint where rework and dissatisfaction begin.
What we offer
Key Features
Insight Engine
Detect claims and coverage confusion to identify and resolve miscommunications early.
Training & Coaching
Use the service team communication guide to equip agents with scripts and coaching for clear, empathetic responses.
Performance Dashboard
Measure resolution speed and member sentiment by tracking handling time, escalation trends, and satisfaction.
Case Management Enrollment Cues
Surface enrollment cues by spotting conversational signals that indicate chronic or high-risk needs.
Employer Reporting
Provide visibility into systemic issues and show how they are being addressed before they escalate.
Real Impact for Your Program
Magic Health helps TPAs and insurance providers deliver clarity, consistency, and confidence across every interaction. By simplifying complex benefit conversations, reducing escalations, and capturing institutional knowledge, the platform improves member retention, boosts Star Ratings, and demonstrates measurable service quality that employers can trust.
Simplify complexity
Deliver clearer answers, reduce escalations, and cut down on rework.
Build confidence
Demonstrate measurable improvements in service quality to employers.
Improve retention
Provide consistent, empathetic guidance that keeps members engaged.
Boost Star Ratings
Drive higher quality scores through clearer benefit explanations.
Strengthen Loyalty
Resolve systemic issues before they affect satisfaction or churn.
Grow Knowledge Base
Capture every learning to prevent repeat mistakes and improve efficiency.
Every interaction is a chance to build trust and engage members around what truly matters to them.
Contact us to know how Magic Health helps TPAs and insurers simplify complexity and improve member and provider experience.