The problem
Insured-member data lived in a distributed architecture, and reimbursement depended on it.
What we built
- Reimbursement engine — adjudicates services delivered by providers and calculates reimbursement; the system's primary settlement tool.
- National registry of covered members — one nationwide database, consolidated and migrated from a distributed architecture.
- Master-data hub — single source of truth for reference data, 200+ dictionaries in active use.
Scope
Business analysis, iterative Scrum delivery, demos, staging and production rollout.
Client name withheld under NDA.