Health Plan Verification

Self-funded plans run on trust. Verq replaces trust with proof.

Verq checks every claim a health plan pays against the plan document that governs it — and turns what it finds into answers for the people who fund the plan and the people who advise it.

I fund a self-funded plan I advise self-funded plans

Continuous Verification · Illustrative Departs from the plan

§4.2 · Schedule of Benefits “Emergency services are covered at in‑network cost‑sharing, regardless of provider…”

Claim: emergency admission adjudicated at 60% out‑of‑network coinsurance — member cost‑share overstated.

→ Written instruction issued to the TPA. Claim reprocessed. On the record.

Found, cited, corrected — and most claims simply match, which is now provable too.

The Problem

The employer holds the risk. The TPA holds the data. Nobody checks.

A self-funded employer carries every dollar of claims risk. The TPA adjudicates the claims — and grades its own homework. The plan document says one thing; whether the claims actually follow it is taken on faith.

A paid-claims report is a total.A number is not an answer.

An annual audit is a sample.A sample is not a record.

“We trust our TPA.”Trust is not verification.

Verq closes that gap — every claim, checked against the plan itself.

How It Works

Three steps. Start with what you already have.

Step 1Week one · document only

Plan Document Audit

Verq reads the plan document itself and surfaces what’s inside it: ambiguities, internal inconsistencies, and provisions a claim decision can’t defend. No claims data needed — just the document already in hand.

Step 2At renewal · data rights

Historical Claims Verification

Every adjudicated claim is checked against the plan and returned with one of three answers. We provide the data-request template.

Step 3Ongoing

Continuous Verification

Every claim checked as it’s adjudicated. And because Verq parses the whole stream against the plan, the same data becomes intelligence: utilization, plan performance, and cash-flow visibility — every number traceable to a cited decision.

The Method

Every claim gets one of three answers.

No jargon. No black box. Every answer carries its citation.

✓

Matches the plan

Paid the way the plan says — cited to the exact section that governs it. Most claims land here. Now it’s provable.

⚑

Departs from the plan

Doesn’t line up with the plan’s terms. Not an accusation — a flag worth a question, an instruction, or a correction.

Needs clarification

The plan is ambiguous or silent. The finding drives a documented interpretation, a written instruction to the TPA, or a note for renewal.

Two Audiences, One Record

Built for the people who carry the plan.

For Employers

You fund every claim.

Find the errors costing you money. Defend your stop-loss reimbursements. Put your oversight on the record.

See Verq for employers →

For Brokers & Consultants

You answer for the plan.

Turn claims oversight into a deliverable your clients can hold — and a reason they choose you.

See Verq for brokers →

Our Story

“The problem isn’t that claims are being processed wrong. It’s that correct decisions can’t be proven.”

Verq founding team

We kept seeing the same scene: a self-funded employer carrying millions in claims risk, a broker responsible for the relationship — and neither able to answer a basic question: is the plan being run the way it’s written?

Claims systems were built to process fast, not to prove later. Verq was built to change that. When every claim is checked against the plan document itself, what’s happening inside a plan stops being a matter of trust and becomes a matter of record.

Medha Parlikar

CEO & Co-Founder

Medha has spent more than thirty years building technology, including two decades shipping production software focused on compliance, big data, and AI. She co-founded Verq to bring a career-long principle to healthcare: records should be verifiable, not simply trusted.

LinkedIn →

Christian Allard

COO & Co-Founder

Christian has spent more than two decades building healthcare products across startups and established health systems. He co-founded Verq to solve persistent healthcare problems by making complex systems clearer, more accountable, and more responsive to the people they serve.