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Everything you need to evaluate, deploy, and operate Cloud Health Office — the integration layer for healthcare payer core administration systems.

Quick Start (Docker) ~15 min

Clone the repo, start the Docker stack, submit a claim through the full adjudication pipeline, and generate an 835 ERA — no Azure account needed.

Get started →

Quick Start (Kubernetes) ~15 min

Deploy the full 25-service platform on Docker Desktop Kubernetes — identical namespace, DNS, and manifests as production Azure AKS.

Kubernetes guide →

CMS-0057-F Compliance

Complete guide to meeting the January 2027 CMS Interoperability and Prior Authorization Rule. Patient Access, Provider Access, Payer-to-Payer, and Prior Auth APIs.

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Architecture

Multi-tenant SaaS platform architecture. Kubernetes-native with Argo Workflows, 36 microservices, 9 adjudication engines, and configuration-driven deployment.

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API Reference

7 production FHIR R4 APIs with OpenAPI 3.1 specs. Patient Access, Provider Access, Prior Authorization, Payer-to-Payer, Claims Scrubbing, Risk Adjustment, and Encounter.

Browse APIs →
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Deployment

From local Docker Compose to production AKS, EKS, or GKE. SaaS signup, self-hosted deployment, GitHub Actions CI/CD, Bicep IaC, and Helm charts.

Deploy →
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Finance Guide

User guide for Premium Billing, Accounts Receivable, Capitation payments, and FFS payment runs. GL accounts, aging, cash posting, and provider contract management.

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Benefit Plan Configuration

Plan hierarchy, coverage tiers, cost sharing rules, accumulators, and network assignment. Configure commercial, Medicare Advantage, and Medicaid managed care benefit structures.

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Claims Adjudication

10-step auto-adjudication pipeline from claim ingestion through payment. Clinical edits, NCCI/MUE, repricing, COB, work queues, and 835 ERA generation.

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Prior Authorization

Authorization requests, decision engine with 400–600+ clinical pathways, lifecycle management, and CMS-0057-F CRD/DTR/PAS API implementation.

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Eligibility & Enrollment

834 enrollment file processing, real-time 270/271 eligibility verification, PCP assignment, FHIR Coverage API, and member coverage lifecycle management.

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Fee Schedule Engine

Fee schedule ingestion pipeline and claim-time pricing engine. Ingest any schedule, price any claim line, audit every decision — sub-millisecond from Redis hot cache.

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Fee Schedule

Medicare RBRVS, Medicaid state schedules, commercial contracted rates, DRG inpatient pricing, multiple procedure reduction rules, and cross-schedule resolution.

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Terminology Crosswalk

SNOMED CT to ICD-10-CM and CPT code translation for CMS-0057 compliance. Context-aware disambiguation, plan-specific overrides, and FHIR ConceptMap/$translate API.

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Provider Verification

Multi-source provider verification and integrity scoring. NPPES, OIG/LEIE exclusion screening, PECOS enrollment, CMS Open Payments, and FSMB license data aggregated into a composite 0–100 score.

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Interested in a platform walkthrough?

Contact our sales team to schedule a guided walkthrough of the platform — claims, authorizations, eligibility, member management, and FHIR R4 APIs. The API Sandbox provides interactive OpenAPI documentation you can explore right now.

Contact Sales →