Healthcare

Modernizing Claims Processing for a Regional Health Insurer

Replaced a 15-year-old claims system with a modern platform that cut processing time by more than half.

Client: Meridian Health Plans

-58%
Claims processing time
-34%
Manual review rate
4x
Regulatory changes shipped per quarter

Meridian Health Plans was running claims through a mainframe system that took days to adjudicate straightforward claims and made every regulatory change a multi-month project. We rebuilt the platform incrementally, migrating claim types one at a time so the business never had to stop processing.

The new platform pairs a rules engine that adjusters can actually configure with automated fraud checks that used to be entirely manual.

Industry

Healthcare

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