Augment legacy claims platforms without the $2M+ Upgrade
Deploy FHIR compliance & prior auth automation in <1 hour.
Stop funding 18-month core system overhauls.
Implementation: $50k-250k • Deploy same day • No vendor lock-in
Request DemoThe Trap
💸 Upgrade Cost Explosion
Healthcare Payer Software quotes: $2M-5M for FHIR compliance alone. Professional services fees rival your annual IT budget.
Cloud Health Office: $50k-250k implementation, <1 hour deployment.
⏳ 18-Month Death March
Core system upgrades require business transformation, data migration, regression testing. Your roadmap is held hostage.
Cloud Health Office: Deploy compliance layer without touching core systems.
🔒 Vendor Lock-In
Switching costs are prohibitive. You're paying 20% maintenance fees annually for software that hasn't fundamentally changed since 2010.
Cloud Health Office: Open-source core, deploy to your Azure tenant.
🚫 No Multi-Payer Support
Every clearinghouse, every TPA, every value-based arrangement requires custom integration work. Your EDI backlog grows faster than you can hire.
Cloud Health Office: Multi-tenant by design, unlimited payer support.
📊 Manual Prior Auth Hell
12-day average prior auth turnaround. Fax machines in 2026. Your providers are threatening to drop your plans.
Cloud Health Office: Automated 278 workflows, <2-minute turnaround.
🔐 Security Theatre
Public endpoints, shared secrets, no audit trails. HIPAA compliance is aspirational, not architectural.
Cloud Health Office: HIPAA-native: Private Link, HSM keys, full audit logs.
The Cloud Health Office Advantage
- FHIR R4 API Compliance: CMS-0057-F Patient Access API ready. Deploy FHIR layer without touching QNXT/Facets.
- Real-Time Prior Authorization: Automated 278 request/response workflows. Cut turnaround from 12 days to <2 minutes.
- Multi-Clearinghouse Support: Connect to Change Healthcare, Availity, Waystar, Relay Health via unified API. Add new clearinghouses in <1 day.
- X12 EDI Automation: 275, 276, 277, 278, 834, 835, 837 workflows included. Production-tested with 480+ test cases.
- Zero-Code Deployment: Config-driven payer onboarding. Add new trading partners via JSON, no custom development.
- Azure-Native Architecture: Logic Apps Standard, Service Bus, Data Lake Gen2. Scales to millions of members.
- Deployment Options: Managed SaaS or self-hosted in your Azure tenant. You choose the model.
- Open-Source Core: Apache 2.0 license. Fork, modify, extend. No vendor lock-in. Ever.
Case Study: Regional MA Plan (250k Members)
Challenge: CMS-0057-F FHIR compliance deadline + 18-month QNXT upgrade backlog. TriZetto quoted $2.3M and 14 months.
Solution: Deployed Cloud Health Office FHIR compliance layer in 45 minutes. Left QNXT core system untouched.
Results:
- Total implementation cost: $85k (vs $2.3M quoted)
- Deployment time: 45 minutes (vs 14 months)
- Prior auth turnaround: 12 days → 90 minutes
- Provider satisfaction scores: +34% in 90 days
- Annual savings: $1.8M+ (avoided upgrade costs + operational efficiency)
"We went from 'this is impossible' to production in under an hour. Cloud Health Office saved our provider network."
— VP Technology (anonymized)
Technical Architecture
How It Works
Cloud Health Office sits between your core system (QNXT/Facets) and external parties (clearinghouses, providers, CMS):
Claims Platform → Cloud Health Office → Clearinghouses
↓
FHIR API (CMS-0057-F)
↓
Member/Provider Apps
Key Components:
- FHIR Gateway: Translates QNXT data to FHIR R4 resources (Patient, Coverage, ExplanationOfBenefit)
- EDI Orchestration: Logic Apps Standard workflows for 275/276/277/278/834/835/837
- Prior Auth Engine: Automated 278 request routing with real-time status tracking
- Multi-Tenant Isolation: Separate Azure Service Bus namespaces per payer/clearinghouse
- Audit Trail: Every transaction logged to Data Lake Gen2 with 7-year retention
No Changes to Core Systems: QNXT/Facets continue operating as-is. Cloud Health Office reads via database views (read-only) and writes via HL7/API.
ROI Calculator
| Cost Factor | Traditional Upgrade | Cloud Health Office |
|---|---|---|
| Implementation Cost | $2M - $5M | $50k - $250k |
| Deployment Timeline | 12-18 months | <1 hour |
| Annual Maintenance | 20% of license ($400k+) | Included |
| Professional Services | $500k - $1M | $0 |
| Total 3-Year Cost | $3.2M - $7.2M | $50k - $250k |
Average Savings: 82%+ reduction in total cost of ownership
Feeling trapped by your curent vendor?
Schedule a 30-minute technical deep-dive to plan your escape:
✓ Live FHIR API compliance demo
✓ Real-time prior auth workflow
✓ Your custom deployment estimate
Or explore the open-source codebase on GitHub →