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Healthcare: Payors and Plans

How InRule Helps Healthcare Payors and Plans

InRule helps healthcare payors and plans keep up with evolving logic and business rules related to changing government regulations and competitive market forces.

Leading healthcare plans and payors have trusted InRule in the following business-critical applications:

  • Claims Adjudication (healthcare and pharmaceutical)
  • Online broker quoting tools
  • Product configuration and pricing
  • Benefit verification and cost estimation
  • Provider file processing
  • Third party Medicare/Medicaid collections
  • Eligibility determination and enrollment
  • Health plan underwriting
  • Data validation