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Healthcare: Payors and Plans

Empowering Healthcare Payors

InRule gives healthcare insurers no-code automation tools to eliminate errors, speed claim resolutions, comply with government regulations and adapt to changing market forces. Leading healthcare payors rely on the InRule® AI Decisioning Platform to perform vital functions, including:

Claims Adjudication

Speed insurance adjudication, from payment calculation and intake through flawless, instantaneous decision and process automations.

Instant, Accurate Policy Quoting

Satisfy online shoppers and ensure application completion. Create and customize insurance coverage quotes quickly that are competitive and compliant.

Benefit Verification and Cost Estimation

Predict patient needs based on machine learning analysis of historical data. Instantly verify benefit qualification and pricing for procedures, visits, and prescriptions.

Third-Party Medicare and Medicaid Collections

Speed collections involving third-party platforms. The InRule® Intelligence Automation Platform is designed for compatibility with multiple external sources.

Eligibility Determination and Enrollment

Determine patient eligibility and enrollment status instantly with automated rules created and managed by subject matter experts, simplifying and speeding processing.

Delta Dental Modernizes Legacy Quoting Platform with Salesforce® and InRule®

For more than 50 years, Delta Dental of Wisconsin has offered benefit services, claims processing, plan administration and services to employers within the state. The organization proudly serves more than 1.8 million subscribers and their family members.

By leveraging Salesforce and InRule, Delta Dental was able to create an online quoting portal that reduced the time it takes to make changes to new rating plans by over 200%.


“We have set up some pretty complex calculations in InRule, and being able to show the actuarial team what the math really looks like in a simple, straightforward language gives them confidence that the logic we have implemented is correct and aligns with their expectations.”

Tyler Leinweber, System Analyst, Delta Dental of Wisconsin

Fierce Healthcare: ‘Well-intentioned, poorly executed waste’: How tech companies aim to reduce billions in wasteful spending

“Because healthcare is so complex, there are lots of opportunities for computing, explained Rik Chomko, CEO of InRule Technology…

“It’s very rules-driven because that’s the agreement that everyone’s said: ‘This is how we’re going to do it,’” Chomko said of the healthcare system. Yet, though InRule relies a lot on artificial intelligence and machine learning, it wants to make that automation accessible, he said. If the goal of technology is to empower humans, they should be kept in the loop. That’s why InRule’s software can be adjusted by users without programming knowledge, he noted….”