Payments, claims, eligibility, contract management, compliance and reporting—all in one managed platform that scales with you.
Flume Workflow Engine™
Trigger events + conditional logic dynamically affect adjudication, webhooks, and engagement in a no-code environment.
APIs, Webhooks, and EDI
Real-time trading with platform customers, vendors, providers—highly flexible as your plan matures and grows.
View our API Documentation
Member & Client Services
White-label our portal and concierge services, or integrate your own in-house member app and support.
Key features built into Flume OS
Provider Contract Management
Tier networks, manage fee schedules, add wraps, and build custom network configurations
Point Solution Integration
An app store of health point solutions; bring your favorites or use our library of partners
Vendors and clean provider claims are paid in under 14 days
Responsible auto-adjudication with integrated fraud waste & abuse protection, plus rules-based manual review
Stop loss reporting, employer dashboards, and renewal data—all handled by Flume OS
Manage enrollment upfront and ongoing with easy 834 trading
Expertise in all aspects of self-funded plan design to support you every step of the way
Fraud Waste & Abuse
Four integrated clinical editing steps by default
COBRA, Flexible Spending Account, ACA, HIPAA security, ERISA, etc.
Funding Account Integration
Use Flume OS to directly connect your or your self-funded customers' accounts
APIs and Webhooks
Claims, groups, members, member accumulators, support cases, incentives, clinical review
White Labeled Portals
Employer, member and broker portals with your branding
Flume brings relationships with risk carriers, plus expertise, to dial in your plan design and cost
You don't need to build your own network to build a plan—Flume brings contracts and partners to the table
Phone & email support for claims, eligibility, billing, and more, plus optional CRM integrations
Proposals, presentations, sales collateral, member communications, and even training for your team
Member and client services happen in the background without you needing to be involved
Launch multiple plans and experiment over time; measure KPI's and tweak plan design to hit your goals