How IPS Shortens Plan Build from Weeks to Hours
By: Shawn Evans, Founder & CEO
Artificial intelligence is everywhere in healthcare technology solutions, but in my experience, it only matters if it improves the way TPAs, ASOs, and networks operate. I am not interested in theoretical AI or features that live on a roadmap. I am interested in technology that removes real operational constraints inside live administrative workflows.
That is why Integrated Payor Solutions (IPS) has embedded AI plan build automation directly into Encompass+. Plan configuration has always been one of the most time-intensive and resource-heavy parts of administration. If you want to increase capacity, improve onboarding timelines, and reduce downstream errors, that is the place to focus.
Why Plan Builds Limit TPA Growth
Over the years, I have watched strong teams spend weeks interpreting benefit documents, constructing layered logic, testing scenarios, and revising configurations before a plan is fully validated. Even experienced administrators can find themselves caught in cycles of review and rework that slow onboarding and delay revenue.
As timelines stretch, the operational impact grows:
- Implementation queues expand
- Revenue recognition is pushed out
- Senior technical resources remain tied up
- Small configuration gaps appear later as claim issues
That model does not support sustainable growth.
Inside Encompass+, structured inputs allow the system to generate foundational plan logic in hours rather than weeks. Instead of building every rule manually, your team starts with an intelligent framework and applies expertise where it creates the most value, in validation, refinement, and oversight.
The result is measurable operational improvement:
- Shorter build timelines
- Fewer initial configuration errors
- Faster testing cycles
- Greater implementation capacity without increasing headcount
This is not about replacing people. It is about strengthening throughput without adding complexity.
Speed with Safeguards
Speed must be paired with control. I would not deploy automation that compromises compliance or removes accountability from the process.
The AI component we use leverages document intelligence to parse complex plan documents. It applies machine learning to extract and structure benefit information from unstructured text, reducing the manual effort required to interpret plan details before configuration begins.
That does not eliminate expertise. It strengthens it.
Experienced administrators still review and validate every plan before final approval. Human expertise remains central to confirming benefit intent, customization requirements, and regulatory alignment before anything goes live.
Keeping human expertise in the loop protects:
- Compliance requirements
- Downstream claims integrity
- Employer-specific nuances
- Administrative accountability
For organizations navigating the No Surprises Act, accurate interpretation of plan data directly supports broader transparency obligations. Transparency+ complements Encompass+ within the same ecosystem, giving TPAs a unified environment for cost estimation, claims processing, and regulatory support.
AI improves the way information is structured at the front end. Final authority remains with experienced administrators.
Built to Scale
We built Encompass+ on Salesforce because flexibility matters. Your business evolves. Employer groups expand. Regulations shift. Networks change. A rigid platform cannot keep up with that reality.
By operating on a dynamic cloud infrastructure, Encompass+ allows plan logic, workflows, and reporting structures to adapt as your organization grows. Customization is not an afterthought. It is built into the foundation.
IPS aligns its pricing with client success. There is no implementation fee, and we do not begin billing until you are fully live. Our per-member-per-month model reflects a simple principle: we grow as you grow. AI plan build automation reinforces that partnership by accelerating time to launch and improving throughput from day one.
Efficiency as Competitive Advantage
In the self-funded market, speed influences market position. When plan builds move from weeks to hours, organizations launch faster, recognize revenue sooner, and operate with greater consistency across the administrative lifecycle.
AI inside Encompass+ does not replace expertise. It removes friction from one of the most time-consuming administrative processes, allowing teams to focus on strategy, service, and growth.
IPS deployed AI to solve a real operational constraint TPAs face every day, because technology should make life easier.
If you are evaluating how this fits into your organization, the questions below provide additional clarity.
Frequently Asked Questions
What is Salesforce, and why does it matter for TPAs?
Salesforce is a leading cloud-based enterprise platform for managing complex data, workflows, and reporting. Because Encompass+ is built on Salesforce, TPAs benefit from a secure, scalable infrastructure that supports customization, integration, and long-term adaptability without relying on legacy systems.
How does AI-supported plan configuration support the No Surprises Act compliance?
The No Surprises Act requires accurate cost-sharing calculations and adherence to federal patient protection standards. Precise plan configuration is foundational to meeting those requirements. By reducing manual errors and standardizing benefit logic, AI-assisted plan builds help strengthen claims accuracy and overall compliance readiness.
What does “human-in-the-loop” mean within IPS’s AI capabilities?
Human-in-the-loop means AI assists with plan configuration, but experienced administrators retain full review and approval authority before any configuration is finalized. IPS embeds automation within its cloud-based Encompass+ platform while maintaining expert oversight, ensuring customization, accuracy, and compliance remain under client control.
