TALON and Smart Data Solutions Deepen Strategic Partnership, Expanding UAPA™ Repricing Across the SDS Clearinghouse

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 SDS claims workflow

PORTSMOUTH, N.H. and EAGAN, Minn., June 25, 2026 (GLOBE NEWSWIRE) -- TALON, the leader in healthcare price transparency, and Smart Data Solutions (SDS), a leading healthcare process 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 SDS's 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, derived from the weighted average of payer-negotiated rates across nearly every provider and payer contract in the country.

The TALON–SDS integration closes that gap at the earliest point in the claims data stream. As the partners extend the integration to additional SDS clients, more payers and TPAs gain access to a transparent, defensible price signal before adjudication begins.

What's Expanding

The TALON–SDS pathway routes claims submitted through SDS's EDI clearinghouse into TALON's Universal Repricer, which processes EDI 837 transactions via batch SFTP 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:

• Batch EDI 837 repricing via SFTP, embedded directly in the SDS 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 SDS's existing clearinghouse connectivity for new TALON client implementations
  
  

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
  
  

Mark Galvin, Founder and CEO, TALON: "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. 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 SDS's clearinghouse is how that price signal reaches the market at scale."

April Gill, Chief Growth Officer, Smart Data Solutions: "Our work with TALON continues to deliver real change for our the healthcare industry, and we're excited to bring UAPA™ and Universal Repricer to continue this transformation. Embedding a transparent, market-weighted price signal into our workflow gives TPAs and payers measurable gains in pricing accuracy, plan performance, and member satisfaction."

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 (SDS) is a technology leader in healthcare process automation and interoperability, helping payers and providers digitally transform operations and improve outcomes. With an AI-native platform powering solutions including Digital Mailroom, Clearinghouse, Intelligent Medical Records, and Prior Authorization Automation, SDS partners with more than 500 healthcare organizations, processing hundreds of millions of EDI-driven transactions annually for TPAs, payers, and providers to streamline complex processes and build a more connected healthcare ecosystem. SDS is HITRUST-certified, CAQH CORE-compliant, and EHNAC-accredited.

Learn more at sdata.us.

Media Contact — TALON Matthew McCormick, VP of Growth Strategy, TALON marketing@talonhealthtech.com | talonhealthtech.com

Media Contact — Smart Data Solutions media@sdata.us | sdata.us

Legal Disclaimer:

EIN Presswire provides this news content "as is" without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.