Overview
A leading New Mexico healthcare Payer was constrained by its outdated, rigid claims management system that lacked the flexibility and analytics capabilities to meet emerging business needs. The resulting inefficiencies, rising costs, and poor customer experiences threatened business sustainability.
CitiusTech took over the troubled implementation from another vendor and partnered with the client to successfully implement HealthRules Payer (HRP) - a modern, automated platform built to transform operational metrics and power digital innovation. The solution reduced time-to market for new product launches by 40%, increased auto adjudication rates by 10%, and provided enriched self-service options for over 750K+ members.