Series

Technology Infrastructure

The technology stack most level funded TPAs operate was not assembled badly; it accumulated under constraint over decades. The claims engine is too old for real-time routing. The CRM was extended beyond its design. The member app serves the broker's RFP. The claims data the employer legally owns may be practically inaccessible. Series 13 identifies each constraint so the product architecture of Series 15 can address it.

LFP-13.01

The TPA Technology Stack: What Vendors Claim vs. What Actually Runs

The vendor demo shows clean arrows between modules. What runs is a claims engine from the late 1990s, an eligibility system acquired with a book of business, and a reporting module …

LFP-13.02

Salesforce and the Integration Problem: The Wrong Architecture and the Workarounds That Make It Worse

Salesforce does CRM well. It was not designed for plan lifecycle management, eligibility exception processing, or stop loss tracking. TPAs that built operational infrastructure on …

LFP-13.03

The Domain Knowledge Problem: Why Technology People Who Do Not Understand Benefits Build the Wrong Systems

Frederick Brooks argued in 1975 that the essential difficulty in software is understanding the problem domain, not writing code. TPA technology fails at the boundary between …

LFP-13.04

AI in TPA Operations: What Is Genuine Capability and What Is Legacy Systems in New Marketing

Rules engines relabeled as intelligent automation. Statistical models from two decades ago repackaged as machine learning. Genuine AI would identify high-cost members months before …