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Meet the CMS-0057-F FHIR Mandate Without Replacing Your Core System

Deploy a compliance layer alongside QNXT, Facets, or HealthEdge in weeks. Then modernize domain by domain, on your timeline.

PMPM, pilot-scoped • Weeks to deploy, not months • Source-available core

Apply for the Founding Client Program → Schedule a discovery call →

Deadline: January 1, 2027

Every Medicare Advantage and Medicaid plan must expose FHIR R4 Patient Access APIs by this date.

Our Compliance Accelerator deploys alongside your existing core — so you meet the mandate without a multi-year replatform.

Progressive modernization

Keep the core. Add capabilities by domain.

Start with the compliance surface, connect claims workflows next, then expand into financial and provider operations without forcing a single cutover event.

An existing payer core stays in place while a secure integration layer connects progressively added compliance, claims, financial, and provider modules to modern digital channels and an evidence store.
Layer 1Deploy the compliance and interoperability surface beside the current core.
Layer 2Move selected domains onto modular services as business constraints allow.
Layer 3Expand toward a complete CAPS platform without a forced rip-and-replace.
A conceptual strangler-fig path: the sequence and scope are tailored to each payer’s systems and risk profile.

Founding Client Program: Be the First Deployment

Where we honestly are: we are pre-pilot. No health plan is running Cloud Health Office as their system of record yet, and we would rather say that plainly than dress up a demo as a customer story.

What the first client gets: zero licensing cost, direct access to the engineers building the platform, and deployment terms shaped around your CMS-0057-F timeline — in exchange for being our first reference deployment.

Apply for the Founding Client Program →

What You Get

Four outcomes, all running alongside your existing core — no replatforming required.

FHIR R4 Compliance Layer

Meets the CMS-0057-F Patient Access API requirement, reading directly from your existing core data. No data migration.

Prior Authorization Automation

Replaces manual and fax-based review with automated request/response workflows and real-time status — typically under two minutes for eligible requests.

Multi-Clearinghouse EDI

One connection to Change Healthcare, Availity, Waystar, and RelayHealth, covering the full set of payer EDI transactions. New clearinghouses added in about a day.

Progressive Modernization Path

Replace one domain of your legacy core at a time, on your schedule. Your core stays the system of record until you choose to cut over a domain — low-risk, no big-bang migration. Provider enrollment verification is included, gating claims before they're paid.

Why Believe Us

See the evidence → Browse the source →

Compliance is the entry point, not the ceiling. A full core administrative platform — claims, accounts receivable, premium billing, capitation, and provider payment — runs underneath. See the full platform →

See it on your own core system

Schedule a 30-minute technical deep-dive, tailored to QNXT, Facets, or HealthEdge.

Schedule a Deep-Dive →

Or explore the source-available codebase on GitHub

Your cloud, your data Deploy in your own Azure, AWS, or GCP subscription. You own it permanently.
PHI never leaves your walls No black-box vendor access to member data. Processing stays inside your environment.
Private endpoints Network-isolated services with no public IP addresses exposed.
Full audit evidence Every claim outcome carries a connected lifecycle and audit ledger you can inspect.

Ready to meet CMS-0057-F on your terms?

Apply for Founding Client → Schedule a call