Building on an established integration, the partners are extending TALON’s Universal Repricer and UAPA™ pricing intelligence to more health plans, TPAs, and self-funded employers within the Smart Data Solutions claims workflow.
Portsmouth, NH and Eagan, MN — June 25, 2026 — TALON, the leader in healthcare price transparency, and Smart Data Solutions, a leading healthcare workflow automation company, today announced the next phase of their strategic partnership, broadening access to TALON’s Universal Repricer and UAPA™ (Universally Acceptable Payment Amount™) technology across Smart Data Solutions’ EDI clearinghouse infrastructure.
With the integration already in production, the partners are now scaling adoption so that more health plans, TPAs, and self-funded employers can apply evidence-based repricing inside their existing clearinghouse workflow, without added operational lift.
Why This Matters Now
Healthcare claims processing has long suffered from a fundamental information gap. By the time a claim reaches adjudication, the opportunity to apply market-accurate, evidence-based pricing is often lost to legacy fee schedules, opaque network contracts, and manual repricing workflows. The result is systemic overpayment, representing a meaningful share of the estimated $500 billion in annual employer healthcare overspend driven by system opacity.
Today’s dominant pricing models compound the problem. Reference-Based Pricing (RBP) programs typically rely on Medicare multiples that diverge from commercial market rates and face growing legal and provider-relations challenges. Traditional network “discounts” begin from inflated chargemaster rates, applying reductions that don’t reflect a true market-clearing price, driving disputes, balance-billing risk, and hidden costs.
UAPA™ corrects both distortions by anchoring payment to the prices providers most commonly accept.
UAPA™ is derived from the weighted average of payer-negotiated rates across nearly every provider and payer contract in the country. The TALON–Smart Data Solutions integration closes the claims-pricing gap at the earliest point in the claims data stream. As the partners extend the integration to additional Smart Data Solutions clients, more payers and TPAs gain access to a transparent, defensible price signal before adjudication begins.
What’s Expanding
The TALON–Smart Data Solutions pathway routes claims submitted through Smart Data Solutions’ EDI clearinghouse into TALON’s Universal Repricer, which processes EDI 837 transactions and returns repriced claims using UAPA™ rates — or any rates for which TALON has configured, including all payer-published in-network negotiated machine-readable files.
With this next phase, partners and clients gain expanded access to:
- EDI 837 repricing, seamlessly integrated into the Smart Data Solutions claims routing workflow
- UAPA™ evidence-based rates applied at the clearinghouse level, reflecting actual market rates rather than negotiated fee schedules or legacy UCR benchmarks
- Claim audit functionality that flags pricing anomalies before adjudication
- Compatibility with 16+ claims administration platforms already integrated with TALON’s platform
- Streamlined onboarding that leverages Smart Data Solutions’ existing clearinghouse connectivity for new TALON client implementations
Addressing the Repricing Challenges Facing Self-Funded Employers
The expanded integration addresses the most common and costly repricing challenges facing self-funded employers and their administrators:
- Replace national wrap networks in direct-to-employer provider contracting with a market-weighted benchmark
- Price out-of-network claims with a transparent, defensible market rate rather than Medicare multiples or UCR estimates
- Supplant failing RBP programs with a provider-accepted alternative that improves first-pass claim acceptance and reduces balance-billing exposure
- Execute full network replacement using UAPA™ as the operating benchmark across an employer’s entire plan design
“Healthcare has never had a trusted price signal. UAPA™ changes that. By tying payment to what providers already accept, we improve first-pass claim acceptance, materially reduce balance-billing risk, and compress costs to support employer growth.”
Mark Galvin
Founder and CEO, TALON
“Every functional market operates on transparent pricing with regulated exchanges, settlement, and clearing that are auditable and provable. American healthcare consumers, the self-insured employers who bear the majority of non-emergent costs, and the providers who deliver care deserve nothing less. Extending UAPA™ deeper into Smart Data Solutions’ clearinghouse is how that price signal reaches the market at scale.”
“Our work with TALON continues to deliver meaningful change for the healthcare industry, and the addition of UAPA™ and Universal Repricer extends that impact.”
April Gill
Chief Commercial Officer, Smart Data Solutions
“By embedding a transparent, market-weighted price signal directly into the workflow, we enable TPAs and payers to achieve measurable improvements in pricing accuracy, plan performance, and member satisfaction.”
Health plans, TPAs, and self-funded employers can now apply evidence-based repricing earlier in the claims workflow, without adding operational lift.
Learn how TALON brings UAPA™ repricing into the claims workflow
About TALON
TALON is the leader in healthcare price transparency. Founded in 2014 and headquartered in Portsmouth, NH, TALON invented true price transparency for U.S. healthcare consumers using a cloud-based machine learning price transparency platform. In 2018, TALON’s platform was demonstrated to federal regulators and served as the model for the Transparency in Coverage Rule. Today, TALON is the only compliant healthcare transparency platform fully integrated from pre-to-post-care, serving health plans, TPAs, and self-funded employers across the country.
TALON’s next-generation UAPA™ (Universally Acceptable Payment Amount) technology applies weighted average commercial pricing data across 400+ payers to produce evidence-based reimbursement rates for 50+ million services, delivering the pricing intelligence that makes real market competition in healthcare possible.
Learn more at talonhealthtech.com.
About Smart Data Solutions
Smart Data Solutions is an AI-native platform company redefining healthcare operations through intelligent workflow automation and connectivity. Serving more than 600 healthcare organizations, Smart Data Solutions delivers a foundational intelligence engine that unifies intake, data, and workflows, enabling payers, TPAs, and providers to move beyond fragmented processes and operate with trusted, decision-ready information.
The platform powers solutions including Digital Mailroom, Clearinghouse, Document Intelligence, and Prior Authorization Automation, supporting over 2 billion transactions and over 500 million documents annually. Smart Data Solutions is HITRUST-certified, CAQH CORE-compliant, and EHNAC-accredited.
Learn more at sdata.us.
Media Contacts
TALON
Matthew McCormick, VP of Growth Strategy
marketing@talonhealthtech.com
talonhealthtech.com
Smart Data Solutions
Reena Joseph, Director of Marketing
marketing@sdata.us
sdata.us
TALON is a healthcare technology company focused on restoring market function in healthcare by making price transparency actionable. Making Healthcare Make Sense.
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