fact_check
Eligibility
Eligibility verification
Confirm in real time whether a beneficiary is active with the operator before care. Live in v2.
TISS/TUSS Gateway
One integration to reach every insurer
Medpro.opg is the interoperability gateway that standardizes communication between healthcare providers and insurers. Integrate once and exchange eligibility, authorizations, claims and billing with every operator — on Brazil's ANS TISS standard.
POST /v1/eligibility/check
Request
{ "beneficiary": "700000…", "operator": "ans-0001" }Response
{ "eligible": true, "plan": "active" }verified
ANS standard
TISS v4.03.00
hubOne API. Every registered operator. Zero point-to-point integrations.
SandboxStart testing without calling real operatorsIntegrating with insurers hurts
Every operator has its own endpoint, rules and support. Without a gateway, integration cost grows with every new contract.
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Point-to-point integration
A new integration for every operator — duplicated code, endless maintenance and contracts blocked on IT.
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Manual checks
Eligibility and authorization verified by hand in the operator portal, delaying care and creating rework.
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Denials and rework
Non-standard claims come back denied. With no audit trail, disputing a denial turns into an investigation.
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A moving standard
ANS updates the TISS standard periodically. Tracking XSDs and versions is a project on its own.
How we solve it
Connect once. Reach every operator.
Medpro.opg sits between your system and the operators. You speak a single TISS language; we handle translation, validation and delivery to each operator.
One gateway, the full TISS cycle
From eligibility checks to batch billing, every TISS transaction family runs through a single API contract — validated against the official ANS XSDs.
- check_circleReal-time beneficiary eligibility
- check_circleAuthorization request and tracking
- check_circleClaim lifecycle and batch billing
- check_circlePayment statements and denial appeals
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Sync and async
Immediate responses where the operator supports it, or webhook callbacks when processing is asynchronous.
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Validation on ingress
Every request is validated against the official ANS XSD schemas before it reaches the operator.
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Per-operator adapters
Each operator has its own adapter. Nothing changes on your side when we add a new one.
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Persisted status
Every transaction is persisted with a canonical status — query the state of any claim by ID.
Everything the TISS cycle requires
approval
Authorization
Authorization requests
Request and track procedure authorizations through the same API contract.
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Claims
Claim lifecycle
Create, submit and manage TISS claims with status tracked end to end.
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Billing
Batch billing
Submit billing batches and track payment statements and denial appeals.
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Webhooks
Signed callbacks
Signed webhooks (HMAC-SHA256), with exponential retry and manual replay for troubleshooting.
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Multi-tenant
Tenant isolation
Separate sandbox, homologation and production environments, with scoped API keys.
In three steps
From API key to first transaction
01
Integrate once
Register your tenant, generate a scoped API key and point it at the gateway. No per-operator integration.
02
Send on TISS
Send eligibility, authorization, claims and billing through one contract. We validate against the ANS XSD on ingress.
03
Receive the response
Synchronous responses where possible, or signed webhook callbacks. The full history stays persisted and auditable.
Compliance and security from the ground up
Built against the official ANS standard, with isolation, auditing and a complete trail from day one.
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TISS v4.03.00
Compatible with TISS 4.00 through 4.03, validated against the official ANS XSDs.
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Signed webhooks
HMAC-SHA256 signed delivery, with retry and dead-letter for failed correlations.
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Multi-tenant isolation
Tenants isolated across storage, runtime and operations.
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Full audit trail
Audit trail of every request, response and administrative action.
Ready to reach every operator?
Talk to a Medpro.opg specialist and start testing in the sandbox today — without calling real operators.