For health plans and TPAs
Your plan funds the card. Rivendell finds, books and pays. The member sees what the demo shows.
Who it is for
Health plans, third-party administrators, reference-based-pricing vendors and health shares. Members use it through their plan. Rivendell runs its own level-funded plan on this rail in California.
What the plan funds and what Rivendell does
The plan funds a card. A member's request arrives by email or in the member app. Rivendell finds three providers with cash prices and confirmed availability, books the one the member picks, pays on the card at the provider, and matches the receipt to the booking. The AI maps the request and drafts the calls. A person confirms the price and the appointment. The card pays.
What to send and what comes back
Send 20 claim lines: CPT code, zip or NPI, allowed amount. Nothing else, so no member data changes hands.
Within 5 business days you get a side-by-side for those lines: your allowed amount, Medicare for the same setting, the posted cash price with its source and date, and the price Rivendell confirmed by phone, with totals.
Pricing
$75 per booked episode. $5 per card-only payment. No per-member fee.
The pilot
20 episodes in 60 days, $1,500 prepaid. The unused part of the prepaid amount is refunded if the pilot ends early. What the pilot includes.
Send your claim lines
Or email them to care@rivendell.health.
Questions operators ask
Who holds the money?
The plan funds the card. Payments to providers draw on the plan's funds. Rivendell never holds plan assets in its own account. The funding structure is set out in the written agreement.
Does this work with HSA-qualified plans?
Yes. For members on HSA-qualified plans, the card draws from the member's HSA for care before the deductible is met. The plan stays HSA-compatible.
What happens when a provider refuses the card?
Rivendell pays by another method the provider accepts. The member never pays at the counter.
Which states?
We book and pay anywhere in the US. Plan administration pieces are reviewed state by state.
Do you sign a BAA?
Yes. A business associate agreement is signed before any member data reaches Rivendell. The claim lines you send for the side-by-side are de-identified: CPT, zip or NPI, allowed amount. No names, no member IDs.
How are prices verified?
Every price is a posted price from a named source with the date we read it, or a price confirmed by phone with the date of the call. The provider's quote at booking governs. We never show an estimate.
What does the AI do, and what does it not do?
The AI maps the request to a service, drafts the calls to providers and drafts the options. A person confirms price and availability before anything is booked. The AI never decides coverage.
What are you not?
Not insurance. Not a provider network. Not a discount medical plan or discount card. Rivendell finds, books and pays for care on a card the plan funds.