Payer Core Platforms
Emids modernizes the core admin system your health plan runs on. The cutover lands cleanly for your members, the configuration stands at audit, and the operating model is ready for the next line of business you take on.
Talk to a payer platform expertA core admin system shapes every claim, every benefit, every member.
Claims, benefits, enrollment, and provider data all move through the core admin system. When that platform ages, the whole health plan feels it. Complex configuration makes every change risky. Misconfigured rules produce payment errors and compliance exposure. Legacy architecture cannot carry Medicare Advantage growth, new lines of business, or the cost targets leadership now holds. The fix is the assessment, the configuration discipline, the migration plan, the integrations, and the operating model built around the platform.
We meet you wherever your platform is in its life.
From the first assessment to the platform running in production, the work stays with one team that knows payer platforms.
System Assessment & Vendor Selection
Define the platform strategy and roadmap. Pin down the business driver behind the change, whether regulatory, modernization, or consolidation. Run needs analysis against a proprietary requirements matrix that carries 5,000+ predefined requirements, weigh build against buy, and select the vendor that fits. The decision rests on evidence the whole leadership team can stand behind.
Platform Configuration Assessment
Audit an existing configuration against vendor best practice. Surface the misconfigurations that drive payment errors and compliance risk, then rank them on a prioritized heat map. A one-week audit shows where the platform is exposed and what to correct first.
Implementation, Configuration & Migration
Plan the implementation, set the solution architecture, and configure the platform to the way the health plan actually runs. Convert and migrate data with automation that holds accuracy through cutover. Members move to the new platform with continuity intact.
Integration & Interoperability
Connect the core platform to the systems around it. Prewired accelerators handle 834, 837, 835, and 270/271 transactions; data warehouse integration and FHIR-based connectivity carry the rest. Claims and eligibility data flow cleanly between every system that needs them.
Operations Support & Transformation
Run core business operations support once the platform is live. Manage business processes, deliver enhancements and upgrades, and re-architect for the next line of business. The platform keeps pace as the business grows.
From platform strategy to production, in six stages.
Every engagement runs the same six stages. Leadership always knows the current stage, the next gate, and what success looks like at it.
Vision
Set the platform strategy, the operating model, and the technology roadmap.
Plan
Build the implementation plan, settle build versus buy, and define the data strategy and governance.
Discover
Gather business and configuration requirements. Produce the solution architecture and blueprint.
Build
Design and validate the configuration, build the integrations, and run automation-led quality assurance.
Deploy
Confirm operational readiness, integrate third-party systems, and move to go-live.
Operate
Stabilize, optimize, and carry process improvement into daily operations.
Where to start depends on what your platform needs most.
Wherever you are with the platform, we plug in alongside your team. You might be exploring a migration, looking for ways to get more from what you already have, or pulling a stalled program back on track.
Platform Configuration Assessment
An independent review of the configuration already in production. One week to audit and identify opportunities, then four weeks to build a sequenced remediation roadmap. A low-commitment way to see exactly where a core platform stands.
Procurement & System Selection
A vendor-agnostic selection service built on 31 years of payer and vendor knowledge. Requirements gathering, RFI and RFP, curated vendor demonstrations, a proprietary scoring matrix, due diligence, and contract support. A confident platform decision, defensible to every stakeholder, in as little as four months.
Core Platform Automation
Intelligent process automation for claims, benefits, and operations, built on the CoreACCEL accelerator library. Bots take on the repeatable processing work across the platform. Engagements target 30 to 50% OPEX savings with documented 3x ROI.
The “as a Service” model
Configuration, testing, integration, and data delivered as productized, right-shored services. Scale a single workstream up or down without standing up a full program. Certified payer-platform teams, predefined accelerators, results measured in months.
Certified expertise across the platforms health plans run on.
What the practice has delivered.
Talk to a payer platform expert
Assessing a configuration. Selecting the next platform. Running a migration. Steadying an implementation that stalled. Bringing down the cost of operations. Start with one conversation about where your platform is and what comes next.