Korva provides AI agents that automate stop loss reimbursement for self-funded health plans, processing claims from first submission to final payment recovery. The platform checks every claim line against policy terms, assembles carrier-specific filing packages, and tracks each submission through reimbursement, replacing manual spreadsheet-based workflows. Korva claims to make reimbursement filing 25 times faster by handling case management and routine follow-ups automatically.
Funding
Funding not disclosed
Founders
Product
Problem
Stop loss is the riskiest part of self-funded health plan operations, yet it remains a largely manual process. Claim reimbursements depend on tedious, error-prone handling of policy terms, carrier-specific paperwork, and ongoing follow-up—creating delays, missed recoveries, and administrative burden for plan administrators.
Solution
Korva deploys AI agents to run the full stop loss reimbursement cycle, from first claim to final reimbursement payment. The agents automatically review every claim line against the specific policy contract—applying deductibles, lasers, and exclusions—so users know what is reimbursable before filing. Korva then assembles complete filing packages with every required form and supporting document in each carrier's required format, prompting users only when a document is missing. After submission, the platform tracks each group, contract, and filing in one place, records carrier responses, and handles routine follow-ups autonomously. Users review and approve outgoing filings, then receive notifications when decisions land or exceptions require attention.
Target Audience
Primary customers are self-funded health plan administrators and third-party administrators (TPAs) who manage stop loss insurance claims and reimbursements for employer-sponsored health plans.
Features
- AI agents apply stop loss policy terms (deductibles, lasers, exclusions) to every claim line to determine reimbursability before submission
- Automated filing package assembly that matches each carrier's specific format and document requirements, with automated requests for missing documents
- Centralized tracking dashboard for every group, contract, and filing showing pending and reimbursed dollar amounts
- Autonomous case management after submission, including logging carrier responses and handling routine follow-ups without user intervention
- User approval workflow that keeps human oversight on outgoing filings while automating the underlying work