Claims & Prior-Authorization Automation
Automate claims intake, eligibility checks, ICD/CPT extraction, routing and prior-auth correspondence with human-in-the-loop controls.
- FNOL/claim intake
- PA case creation
- Denials worklist automation
INDUSTRY
Healthcare & Life Sciences
Patient-centric, compliant platforms — EHR/EMR interoperability, governed lakehouses, and AI-assisted workflows that reduce cycle time and improve outcomes.
HIPAA-ReadyEHR InteropClaims AutomationData GovernanceSecurity Posture
Claim cycle time
↓ 20–40%
Data completeness
↑ across sources
Uptime targets
99.95%+
Secure by design
Zero-trust patterns, PHI guardrails and audit-ready pipelines mapped to HIPAA/GxP controls.
Interoperability
FHIR/HL7 connectors and EHR/HIE ingestion for seamless, governed data movement.
Applied clinical AI
Triage, coding, summarization and knowledge search with monitored, explainable models.
Evidence & audit
Automated evidence packs, lineage and policy-as-code to simplify audits.
Solution bundles
Adopt independently or as a cohesive platform.
HIPAA-Ready Patient Data Platform
Governed lakehouse with EHR/LIS/HIE ingestion, FHIR/HL7 mapping, PHI access controls and analytics for population health and quality measures.
- EHR/EMR ingestion
- FHIR/HL7 mapping
- Lineage, masking & role-based access
Healthcare Data Governance & Interoperability
Establish trusted clinical and admin data with catalog, lineage and metric definitions; enforce access policies and improve interoperability across systems.
- Catalog & glossary
- Quality rules & SLAs
- Policy-driven access & masking
Attack Surface & Vulnerability Risk Reduction
Continuously discover exposed assets and prioritize remediation using risk signals; wire evidence and workflows into existing operations.
- External asset discovery
- Risk-based vuln intelligence
- Remediation orchestration & evidence
Med-Tech Device ID & Prototyping
Concept-to-prototype industrial design for medical/IoT devices with ergonomics and DFM to shorten design cycles and improve usability.
- Handheld diagnostics
- Wearables & enclosures
- Usability & DFM reviews
What we bring
Patterns, accelerators and operating models across Cloud, Data, AI and SRE.
Cloud & Data Foundations
- Landing zones & identity
- Healthcare lakehouse
- Streaming ingestion
- Governance, lineage & PHI masking
AI & Applications
- Document/claims AI & RAG
- ML Ops & model evaluation
- FHIR APIs & app modernization
- Patient/clinician UX at scale
Security & Compliance
- Zero-trust architecture
- Attack surface & risk-based prioritization
- Backup, DR & chaos testing
- Runtime threat detection
Observability & SRE
- SLIs/SLOs for critical services
- Tracing & golden signals
- Cost guardrails & FinOps
- Automated QoS enforcement
Expected outcomes
Fewer denials
Cleaner intake and coding assistance reduce avoidable denials.
Faster time-to-insight
Governed lakehouse improves completeness and query performance.
Staff productivity
Automation offloads repetitive steps across claims and prior-auth.
Compliance posture
Audit trails, data masking and access controls simplify attestations.
Risk posture
External exposure and mean risk trend down via prioritized remediation.
FAQs
How do you handle PHI and HIPAA compliance?
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We implement zero-trust, least-privilege access with masking, tokenization, immutable audit and disaster-recovery controls mapped to HIPAA safeguards.
Do you integrate with our EHR?
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Yes. We use FHIR/HL7 adapters and vendor APIs to ingest clinical and administrative data while preserving provenance and consent.
Can we start small?
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Absolutely. Many clients start with a focused automation (e.g., denials or prior-auth) while the data platform is built in parallel.
Ready to elevate patient and provider experiences?
We’ll align your outcomes to an actionable roadmap across Cloud, Data and AI — secure, compliant and measurable.