LightSpun

The AI-native infrastructure for dental insurance.
(Formerly 32Health)

We are rebuilding dental insurance administration from the ground up. By replacing outdated paper-and-fax workflows with an AI-native platform, we make care faster and more accessible for payers, providers, and patients.

We automate the entire value chain—from credentialing to claims processing.

• 90%+ Claims auto-adjudicated
• <1 Week Provider onboarding (down from 45-60 days)
• 50% Reduction in administrative costs

• Claims Automation: Real-time processing with Generative AI.
• Provider Credentialing: Streamlined verification and onboarding.
• Benefits Management: Next-gen plan design and administration.

A dental insurance TPA (Third-Party Administrator) platform — 37+ microservices, 3 frontend apps, 133+ credentialing crawlers on GCP.

┌─────────────────────────────────────────────────────────────────────┐
│                        FRONTEND APPS                                │
│  plan-config-app (28 clients)  admin-app (26 svcs)  provider-app   │
│  Internal admin UI             Cross-env admin      Provider portal │
└──────────────────────────┬──────────────────────────────────────────┘
                           │ GraphQL + REST
┌──────────────────────────▼──────────────────────────────────────────┐
│                      API GATEWAY (Auth0 JWT)                        │
│          27 route prefixes → Cloud Run services                     │
└──────────────────────────┬──────────────────────────────────────────┘
                           │
    ┌──────────────────────┼──────────────────────────┐
    ▼                      ▼                          ▼
┌─────────┐  ┌──────────────────────┐  ┌──────────────────────────┐
│ ENTITY  │  │   CORE BUSINESS      │  │   PLATFORM SERVICES      │
│ SERVICES│  │   SERVICES           │  │                          │
├─────────┤  ├──────────────────────┤  ├──────────────────────────┤
│member   │  │plan-svc (config)     │  │auth-svc (identity/RBAC)  │
│provider │  │adjudication-svc      │  │event-svc (orchestrator)  │
│group    │  │claim-svc             │  │document-svc (gen/store)  │
│office   │  │rules-engine-svc      │  │communication-svc (email) │
│atlas    │  │manual-claim-svc      │  │notification-svc          │
│address  │  │billing-svc (invoices)│  │correspondence-svc (bulk) │
│broker   │  │financial-svc (pay)   │  │case-management-svc       │
│onboard  │  │ledger-svc (ledger)   │  │audit-log-svc / cx-svc   │
│bulk-load│  │                      │  │bulk-load-svc             │
└────┬────┘  └──────────┬───────────┘  └────────────┬─────────────┘
     │                  │                            │
     └──────────────────┼────────────────────────────┘
                        │ Pub/Sub + Cloud Tasks
    ┌───────────────────┼───────────────────────┐
    ▼                   ▼                       ▼
┌──────────┐  ┌─────────────────┐  ┌────────────────────────┐
│CREDENTIAL│  │  EDI / CLAIMS   │  │   EXTERNAL DATA        │
│ SYSTEM   │  │  PIPELINE       │  │   PIPELINES            │
├──────────┤  ├─────────────────┤  ├────────────────────────┤
│credential│  │edi-service      │  │fdb-workflows (orchestr)│
│v2-svc    │  │edi-to-ada-form  │  │fdb-reports (Looker/BQ) │
│caqh-svc  │  │gcloud-edi-bulk  │  │data-migrator (Az→GCS)  │
│crawler   │  │vyne (library)   │  │pos-asb-fastapi (Az SB) │
│-svc      │  │dentalexchange   │  │careington-workflows    │
│crawlerv2 │  │ada_information_ │  │guardian-cactus-symplr  │
│(133 svcs)│  │  extraction(ML) │  │                        │
└──────────┘  └─────────────────┘  └────────────────────────┘

plan-svc is the source of truth for benefit plans — fee schedules, procedure codes, coinsurance/deductible/maximum rules, networks, plan families. base-svc provides lookup data to the plan-config-app frontend.

group-svc manages employer groups and sub-groups. member-svc stores member demographics and eligibility. bulk-load-svc ingests enrollment files (EDI 834, CSV/Excel). member-eligibility-load-v2-svc handles the dedicated 834 parsing pipeline. Melissa API standardizes addresses via address-svc / address-validation-svc.

provider-svc stores provider profiles. onboarding-svc manages new provider applications. credentialv2-svc orchestrates the full credentialing lifecycle. It dispatches to 133+ crawlers in crawlerv2-svc-monorepo (Playwright-based) that scrape state licensing boards, DEA, NPI, NPDB, OIG, SAM, Medicaid exclusions, and CMS preclusion lists. Results callback via Cloud Tasks. caqh-svc integrates with the CAQH ProView API. careington-workflows exchanges PSV files with Careington via Azure Blob.

Claims arrive two ways:

• Electronic (EDI 837D): Clearinghouses (Vyne, DXC) SFTP files to GCS → fdb-workflows triggers processing → edi-service (EdiFabric) converts EDI→JSON → publishes to Pub/Sub validate-process-adjudicate-claim
• Paper/scanned: Scanned forms → ada_information_extraction (Donut ML model on Vertex AI) → extracts ADA form fields → edi-service converts to 837D → same Pub/Sub topic

manual-claim-svc handles paper claim queuing, FairHealth fee schedule lookups, and attachment retrieval (via vyne/dentalexchange libraries for signed GCS URLs).

The Pub/Sub topic validate-process-adjudicate-claim feeds into the adjudication pipeline:

• rules-engine-svc evaluates benefit rules (frequency limits, age restrictions, waiting periods, maximums, deductibles, coinsurance)
• adjudication-svc and claim-svc share the same adjudication database — parallel views on claims processing (different route prefixes)
• Rules pull plan config from plan-svc, member eligibility from member-svc, provider network status from atlas-svc

financial-svc executes payment runs — generates NACHA files for ACH, prints checks, handles capitation payments. Publishes claim-closing events via Pub/Sub. billing-svc generates invoices for member premiums. ledger-svc maintains the double-entry financial ledger. correspondence-svc triggers bulk document generation (EOBs, IDNs, remittances) via document-svc.

fdb-workflows generates outbound EDI: 999 acknowledgments back to Vyne, 837D encounter files from BigQuery, 834 enrollment diffs to HealthSun. All EDI conversion goes through the central EdiFabric API at edi-translator.32health.care.

• Cloud: GCP (Cloud Run, Cloud SQL PostgreSQL, Pub/Sub, GCS, Secret Manager, Cloud Tasks, BigQuery, Vertex AI)
• Secondary: Azure (Blob Storage, File Share, Service Bus for third-party integrations)
• IaC: Pulumi — 3 GCP projects (dev, UAT, prod)
• CI/CD: Cloud Build with per-service cloudbuild_{env}.yaml
• Environments: dev, uat, uat2, preprod, prod