Rate, underwrite, enroll and adjudicate — with clinical workflows, provider networks and member portals on a single stack.
Product configuration, provider networks, claims adjudication and member engagement — modular, composable and fast to deploy.
Individual, group, supplemental and wellness products — modeled without code. Tiers, riders, deductibles, coinsurance and copays.
Contract, credential and fee-schedule management. In-network / out-of-network routing, negotiated rates, capitation.
Auto-adjudication with clinical edits, coding validation (ICD-10, CPT, HCPCS), and coordination of benefits.
Self-service enrollment, ID cards, EOBs, HSA/FSA tracking. Broker commission and census management.
MLR reporting, risk scoring (HCC/CDPS), utilization dashboards and loss-ratio forecasting.
HIPAA, ACA, MLR, EDI 270/271/276/277/837/835 ready. Full audit trail and role-based access.
Our adjudication engine combines deterministic rules, AI triage and clinical edits to route clean claims straight through and surface only the exceptions.
Join leading carriers who trust Taldar for their digital transformation.