How It Works FAQ Employers TPAs Non-Profits Crowdfunding Specialty & SCA About Client Login Get Started →
Specialty & SCA Networks

Specialty claims,
off paper and
onto a real rail.

Single case agreements and out-of-network specialty claims still move on fax, paper, and mailed checks, one negotiation at a time. My Patient Fund™ brings them onto a standard rail. Providers submit however they already do — even by mail — and the payment comes back the same clean way every time: 100% by EFT, with no interchange taken out and nothing re-keyed by hand.

Schedule a Setup Call → See the Problem
100%
EFT to Provider
0%
Card Interchange
837/835
Standard EDI
The Problem

Three ways specialty &
SCA payments stall.

Out-of-network specialty care gets arranged one case at a time, and too often it's paid the same way — by hand. Every step that stays manual is another place where money, time, or proof can slip through.

Manual
Every agreement is processed by hand
Each single case agreement is negotiated and settled on its own. Plenty of claims still arrive by fax or in the mail, and from there the wait runs 30 to 90 days. Re-keying introduces errors, and staff lose hours chasing the status of payments that should have been automatic.
MPF™: claims onto the rail — paid by EFT, not a mailed check
02
Card payments tax the specialty provider
When an out-of-network payment arrives as a virtual or prepaid card, the provider is charged 3–5% to receive their own money — silently shrinking the rate that was already agreed. The same payment over EFT costs pennies.
MPF™: providers keep 100% — paid via EFT, zero interchange
03
One-off agreements leave no clean trail
A pile of faxed agreements, spreadsheets, and check stubs is not an audit trail. When a sponsor, auditor, or board asks whether a specific agreement was honored and paid at the agreed rate, the answer lives in email — not in a system.
MPF™: real-time 835 ERA + full audit trail — automatic
How It Works

My Patient Fund™ —
flat rate, closed-loop,
complete control.

1
Account Setup
Fund FBO Account
ACH or wire into a dedicated FBO sub-account at our FDIC-insured banking partner, titled in your company's name. Benefit rules set. Flat per-transaction fee — same cost regardless of claim size. MPGI never takes custody of funds.
2
Member Credential
Member Presents My ID
The patient's My ID — in their phone's wallet or as a physical card — shows Payer ID: FUNDS. Presented at the specialty provider like an insurance card. Not a payment card. No upfront cash required.
3
EDI Claim
Provider Submits 837P or 837I
The provider sends the claim to Payer ID: FUNDS the way they bill any payer — through their clearinghouse, or on paper if that's still how they work. It's the same routine they already know, with nothing new to enroll in or install.
4
Payment
Banking Partner Executes EFT to Provider
MPF™ Claim Rules Validator scrubs the claim against sponsor-defined Rules and issues payment instruction. Banking partner executes EFT/ACH directly to provider's bank account — 100% of approved amount. 835 ERA returned via clearinghouse.
5
Reporting
Real-Time Dashboard — PHI Never Disclosed
Live FBO balance, claims activity, payment history by service category and provider type. No diagnosis codes, no clinical details — financial data only per HIPAA architecture.
Real-time payment rail data flow
Quick Reference — Payer ID: FUNDS
Payer IDFUNDS
Claims837P · 837I · 837D
ClearinghouseAll major clearinghouses — Office Ally, Gateway EDI, Change Healthcare, Optum, Availity, Trizetto, Waystar, and more
Remittance835 ERA
Payment RailEFT/ACH — Zero Interchange
Fund CustodyFDIC-Insured FBO
Out-of-Network, Not a Network

Built for specialty care
without becoming a network.

My Patient Fund™ never contracts with providers, negotiates rates, or steers patients. The single case agreement stays between the sponsor and the provider — MPF™ runs the money rail underneath it. That neutrality is the whole point.

"The rail should move the money exactly as the agreement says — and never quietly become the thing that sets the rate."

🧾
The Agreement Stays Yours
The SCA's rate and terms are authored by the sponsor and provider. MPF™ validates each claim against those terms and pays — it never authors coverage rules or negotiates on anyone's behalf.
📊
FBO — Funds Never Commingled
Sponsor funds sit in a dedicated FBO account at an FDIC-insured banking partner, titled in the sponsor's name. MPGI never takes custody, holds, or controls the money.
🔐
HIPAA by Architecture
Providers submit standard claims, and sponsors see only the financial side of them — amount, date, service category, provider type. The clinical detail never leaves the space between patient and provider.
⚡
835 ERA on Every Claim
Every payment returns a standard Electronic Remittance Advice with a complete chain from 837 submission to EFT settlement — the documentation a one-off agreement usually can't produce.
Specialist reviewing claims data
Who It Serves

Who runs on
the specialty rail?

Any arrangement where a provider submits a claim for out-of-network or specialty care — and someone needs to pay it cleanly, at the agreed rate, with proof.

Use Case 01
Infusion & Specialty Pharmacy
On a five-figure infusion or specialty-drug claim, a 3–5% card fee is real money. Here the provider is paid at the rate everyone agreed to, straight to their account by EFT.
Five-figure claims paid 100% by EFT
No interchange skimmed off the top
837P/837I through the existing clearinghouse
Use Case 02
Out-of-Network Specialists
A specialist treating a patient under a single case agreement bills Payer ID: FUNDS exactly as they would any other payer. Payment comes back on a predictable rail, with no card fees and no chasing.
Bill through the existing clearinghouse
Paid at the SCA’s agreed rate
835 ERA returned automatically
Use Case 03
SCA & Case-Management Contractors
Contractors who arrange single case agreements can retire the fax-and-check routine for good. Every agreement runs on one rail, with the full audit trail sitting behind it.
Every agreement on one electronic rail
Real-time status and payment history
Exportable audit trail per agreement
Use Case 04
Specialty & RBP Networks
Networks and reference-based-pricing administrators can route provider payments over a standard rail instead of cutting checks. It's direct EFT, and there's no new clearinghouse to stand up.
Replace checks with direct EFT
Standard 837/835 — no new clearinghouse
Consolidated reporting with per-case drill-down
Side by Side

MPF™ vs. how specialty
gets paid today.

How My Patient Fund™ compares to the ways out-of-network and single-case specialty claims get paid today.

Capability My Patient Fund™ Manual SCA (Paper/Check) Virtual Card Payout In-Network Contract
Fee modelFlat per claimStaff time + float3–5% interchangeNegotiated + admin
Payment railEFT direct — 100%Mailed checkCard network deductionsVaries by payer
Claims workflow837P/I · 835 ERAFax / re-keyCard swipe / portalStandard EDI
FDIC custodyFBO per sponsorNoneCard issuerPayer holds
Audit trailReal-time automaticEmail + spreadsheetsCard statementsPayer system
Provider networkNone — stays neutralNoneNoneRequired

⚠ My Patient Fund™ is not insurance, not a network, and does not negotiate provider rates or contracts. Single case agreements are authored by the sponsor and provider.

Ready to take specialty
payments electronic?

My Patient Fund™ is a sub-clearinghouse that turns single case agreements and out-of-network specialty claims into standard electronic transactions — providers paid 100% by EFT, zero interchange, full 835 audit trail. A neutral rail, not a network.

Payer ID: FUNDS  ·  FDIC-Insured Banking Partner  ·  837P / 837I / 837D  ·  EFT Direct to Provider
Schedule a Setup Call →