TriPay Is Built for Real Time.
Healthcare payments are stuck in 1970. We are fixing them.
Nashville, Tennessee · Seed Round · 2026
Every stakeholder in healthcare is losing at the same time.
Their healthcare costs rise 6 to 10% every year with no clear explanation. Then a network changes and their employees lose their doctors overnight. They pay for the system, but have no control over it.
They trained to care for patients, not chase payment. Up to one in three claims gets rejected, and getting paid can take 60 days if it happens at all. Hospitals are leaving payer networks just to survive.
They never know the real cost until the bill shows up. Then comes the denial, the debt, or both. In this system, getting sick can ruin a person financially.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
Today's claims systems were designed for paper billing, not real-time healthcare payments.
Navigation Platforms
Guide patients through a dysfunctional system. They don't fix it.
Payers
Run batch claims systems built decades ago.
Direct Contracting
Still reconciled through legacy claims processes.
Point Payment Solutions
Fragment the problem. The foundation stays flawed.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
No claim filed.
No prior auth.
No dispute. No delay.
Payment is permissioned and priced before care occurs. Not disputed after.
Legacy systems rely on claims, disputes, and delays. TriPay removes the process entirely.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
The TriPay event engine converts validated care events into instant settlement
Eliminating coding, claims, adjudication, and denials. Reducing admin cost by up to 75%
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
Legacy Claims (EDI/837)
Built on 1970s paper billing logic. Reactive by design. Payment is argued after care, not approved before care occurs.
Payers & TPAs
They move money but they ARE the bottleneck. Opaque pricing. Denied claims. 30 to 60 day delays. They profit from the inefficiency and more process.
RCM & Point Solutions
Faster billing is still billing. These tools patch symptoms on top of the same broken foundation. None of them own the permission layer.
TriPay sits between contracts and care, owning the governance layer no one built. Payment is permissioned before care occurs and settled the moment it happens. No claims. No disputes. No delays. This is not a faster version of the old system. It is a replacement for the logic underneath it.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
TAM — Healthcare = 18% of US GDP
SAM — 25–40% reducible overhead from legacy systems
SOM — ASCs, primary, specialty, dental, behavioral
@ 5–12% transaction fee on settled care events
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Per Member Per Month. Recurring platform access fee per enrolled member. Predictable, subscription-style base revenue.
Think: SaaS base layer
% Fee on each care event settled through TriPay. Scales directly with volume. Up to 75% less than current payers.
Think: Stripe's take rate
Analytics & Pro Services. Practice management, consulting upsells. Expansion revenue on top of core platform.
Think: AWS add-ons
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Chief Executive Officer
Healthcare infrastructure operator and former Cigna leader with expertise in interoperability, AI product strategy, and enterprise transformation.
Chief Medical Officer
Physician founder and healthcare strategist with a national clinician platform. Former ENT surgeon, media entrepreneur, author of Surgeon on the Edge.
Head of Product & Ops
Former Cigna and Evernorth leader who built AI-powered healthcare products and led global teams across enterprise healthcare operations.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
The system is breaking. The technology exists. The team is assembled. The window is open.
The cracks are now impossible to ignore. 16+ health systems have walked out of payer networks in 2026. Employers are suing PBMs and payers. States are trying to break up PBMs. Patients are drowning in $200 billion of medical debt. Every major stakeholder is signaling the same thing: this system is no longer sustainable.
FHIR APIs went live in 2021. Price transparency rules are enforceable. Agentic AI can help automate contract governance and process. Real-time healthcare settlement infrastructure is buildable today. It wasn't possible just a few years ago. It won't be this open a few years from now.
Healthcare interoperability veterans. Cloud infrastructure architects. Risk management operators. We've been inside the system. We know where it breaks. We're here to build the replacement layer.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
healthcare. We are here to
stabilize a dysfunctional system.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
Supplementary materials and detailed technical, market, and operational information can be found in the following slides.
How faster settlement improves employer economics. Traditional claims float compared to TriPay's intentional, event-driven capital control and predictable spend.
How TriPay settles in real time without balance sheet risk. Covers transaction sufficiency, employer settlement reserves, banking infrastructure, and liquidity smoothing.
16+ major U.S. health systems have exited or are exiting payer networks in 2026. Documents recent network breakups and the root causes driving providers out.
The components for real-time settlement already exist. Deterministic pricing, same-day payment rails, and post-event reconciliation are all in place. What is missing is the governing system.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
Employers fund claims after adjudication. Float exists because of delay, not design.
30–60 day lag between care and payment. High administrative rework, denial churn, and unpredictable volatility.
Working capital tied to an inefficient, uncontrolled process.
Employer funds are placed into a structured wallet or escrow, intentionally and predictably. Payment is authorized upfront, not disputed after the fact.
Near real-time settlement tied to verified milestones. Reduced denial rework and admin waste.
Predictable spend, controlled capital flow. Capital timing serves as a governance tool.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
Patient HSA/wallet preauthorization and card authorization at contract trigger. No contract activation without funds verification. Think: hotel reservation model.
Rolling escrow threshold for projected outflow with auto-replenishment triggers. Keeps employer funds always ready.
Sponsor bank FBO accounts for regulated custody and money movement via RTP, FedNow, or Same-Day ACH.
Revolving credit line for timing mismatches. Used for liquidity smoothing, not underwriting risk.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
Source: Becker's Hospital Review
Reimbursement below cost of care
High claim denial rates
Excessive prior authorization burden
Slow or delayed payment cycles
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.
What’s missing is the system to govern them.
Providers already know the price.
They just get forced into a system that pretends they don’t.
Same-day payments in healthcare are possible.
What’s missing is a clear, reliable way to approve and trigger them in real time.
Post-care reconciliation already exists.
It’s slow, manual, and built for conflict.
Despite modern capabilities, the healthcare industry lacks a deterministic, event-driven system to govern permissioning authority before money moves. Until now.
© 2026 TriPay Inc. Proprietary and Confidential. All Rights Reserved.