April 2026

🔵 PoC #1: Flexpa — Insurance Data Aggregator

Replace 6 manual OAuth integrations with 1 unified API call

1-2 days
Est. Time
$0
PoC Cost
High
Impact
High
Priority
1 What It Does

Flexpa is "Plaid for health insurance." Instead of maintaining 6 separate OAuth flows (Aetna, Anthem, Cigna, etc.), you call one API. Flexpa handles the insurer connections and returns FHIR-formatted claims data.

2 How It Fits in Architecture
User selects insurer in app (existing screen)
Flexpa Link SDK — replaces manual OAuth redirect. Patient consents once.
Flexpa API — GET /ExplanationOfBenefits, /Patient, /Coverage
Your backend — stores EOBs in existing DynamoDB (same schema)
Existing app flow — no changes needed downstream
3 Integration Points
// rek-backend/handlers/flexpa/records.js (NEW FILE) const response = await axios.get( `https://api.flexpa.com/fhir/v1/ExplanationOfBenefits`, { headers: { Authorization: `Bearer ${flexpaAccessToken}` } } ); // Returns FHIR R4 formatted EOBs — same structure as existing Aetna/Cigna handlers // Write to DynamoDB using existing storeInDatabase() from common/insurance.js

✅ Pros

  • Replaces all 6 manual OAuth integrations
  • One API call instead of per-insurer flows
  • Sandbox available, free during PoC
  • FHIR R4 — compatible with existing data model
  • Covers 100+ insurers in their network

⚠️ Cons

  • Third-party dependency (Flexpa goes down, you go down)
  • Cost at scale (Flexpa pricing TBD)
  • Different data schema may need mapping
  • Requires patient consent flow change
4 PoC Test Plan
  1. Get Flexpa sandbox API keys (free at flexpa.com/developers)
  2. Build minimal Flexpa Link consent screen in test environment
  3. Connect 1 test insurer (Aetna) via Flexpa
  4. Compare returned EOBs against existing Aetna handler output
  5. Verify data maps correctly to existing DynamoDB schema
  6. Test with real patient account (1 user, 1 insurer)

🟢 PoC #2: Plaid — HSA/FSA Bank Aggregation

Connect HSA/FSA bank accounts to see real-time balances and match transactions

2-3 days
Est. Time
$0
PoC Cost
High
Impact
High
Priority
1 What It Does

Pull HSA/FSA bank account balances and 24 months of transaction history. Then cross-reference transactions against Rekencile claims to show "HSA eligible" badges and remaining balances.

2 How It Fits in Architecture
User links HSA account via Plaid Link SDK (new screen)
Plaid /accounts/get — detect account type = "hsa"
Plaid /transactions/get — pull 24mo of HSA transactions
New Lambda — match HSA transactions against Rekencile EOBs
App shows: HSA balance, eligible claims, reimbursed amounts
3 Integration Points
// rek-backend/handlers/plaid/hsa-matching.js (NEW FILE) // 1. Get HSA transactions from Plaid const accounts = await plaidClient.accountsBalanceGet({ access_token }); const hsaAccount = accounts.data.accounts .find(a => a.type === 'investment' && a.subtype === 'hsa'); // 2. Pull transactions const txns = await plaidClient.transactionsGet({ access_token, start_date: '2024-01-01', end_date: today }); // 3. Match against Rekencile EOBs (date + amount + provider) // 4. Store match results in new HSATransactions table

✅ Pros

  • Covers ALL HSA custodians via Plaid network
  • Balance + transactions + investment holdings
  • Plaid Link is battle-tested (used by 8000+ apps)
  • Free sandbox environment
  • Completes the financial picture with insurance claims

⚠️ Cons

  • Additional permission request for patients (bank access)
  • Plaid pricing at scale (per-linked-item)
  • New screen flow needed in app
  • FSA accounts harder (typically employer-managed cards)
4 PoC Test Plan
  1. Get Plaid sandbox credentials (free at dashboard.plaid.com)
  2. Add Plaid Link SDK to test environment
  3. Link a test HSA account (Fidelity, Lively, Optum sandbox)
  4. Pull balance and transactions
  5. Manually match 3-5 transactions against existing EOB data
  6. Verify "HSA eligible" classification matches IRS Pub 502 rules

🟡 PoC #3: Cost Estimation — Patient Responsibility

Show patients estimated costs before and after insurance claims

3-5 days
Est. Time
$0
PoC Cost
Medium
Impact
Medium
Priority
1 What It Does

Take the EOB data you already pull from insurers and enrich it with contracted rate data to show patients their estimated responsibility before claims process, and track what they've actually paid vs. owed.

2 How It Fits in Architecture
EOB arrives from insurance (existing flow)
New cost-estimation Lambda — cross-references procedure codes (CPT/HCPCS)
Price transparency API — get contracted rate for provider+procedure
Patient dashboard — shows: billed, allowed, patient responsibility, paid
3 Data Sources for Cost Estimates

Option A — DIY with existing EOB data (simplest):

Your EOBs already have: billed amount, insurance payment, patient responsibility. Add an "estimated vs actual" tracker per claim. No external API needed for PoC.

Option B — Change Healthcare Care Cost Estimator API:

Provider-focused. Requires provider NPI lookup. Good for in-network estimates. Has free sandbox.

Option C — CMS Hospital Price Transparency data:

Public data. Large machine-readable files (MRF) from hospitals. Complex to parse but free.

✅ Pros

  • Strong patient value — "what do I owe?"
  • Option A (DIY) needs no external APIs
  • Leverages existing EOB data you already have
  • Differentiator — most apps don't show cost estimates

⚠️ Cons

  • True estimates need contracted rate data (not free)
  • Accuracy depends on data completeness
  • Option B/C require provider-level data
  • Higher complexity than PoC 1 & 2
4 PoC Test Plan
  1. Take 5 existing EOBs from DynamoDB (with real amounts)
  2. Build simple "claim summary" view: billed vs. patient responsibility
  3. Add "payment tracker" — mark claims as paid/pending
  4. Test with 3 patient accounts
  5. If accurate enough → explore contracted rate API for refinement

📋 Recommended PoC Sequence

  1. Week 1: Flexpa PoC — highest ROI, lowest complexity. Replace 1 insurer (Aetna) via Flexpa vs. existing direct OAuth.
  2. Week 2: Plaid PoC — add HSA linking to 1 test user. Verify transaction matching works against existing EOBs.
  3. Week 3: Cost Estimation PoC — start with Option A (DIY on existing EOB data). No external dependencies.
  4. Week 4: Evaluate results. Pick winner(s) for production integration. Discard low-performing PoCs.

📊 PoC Comparison Matrix

Criteria Flexpa Plaid Cost Est.
Time to PoC ⭐ 1-2 days ⭐ 2-3 days ⭐⭐ 3-5 days
PoC Cost Free Free Free*
Replaces Existing Code Yes (major) New feature New feature
Patient Trust Factor High (consent) Medium High
Unique to 1000 Users Yes Yes Yes
Recommended Order #1 #2 #3

*Cost Est. Option A is free. Option B/C have API costs.

🚀 Immediate Next Steps

  1. Today: Get Flexpa developer account → flexpa.com/developers (free sandbox)
  2. Today: Get Plaid sandbox keys → dashboard.plaid.com (free sandbox)
  3. This week: Spin up test Lambda in dev environment for each
  4. Next week: Connect 1 Aetna user via Flexpa vs. existing flow — compare outputs
  5. Decision criteria: Data completeness, accuracy, ease of integration, cost at 1000 users