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v4.0.0  ·  Production SaaS  ·  531 Tests  ·  Zero Vulnerabilities

The Integration Layer
Health Plans Have Been
Waiting For

Avoid $2M+ upgrades. Achieve CMS-0057-F compliance 18 months ahead of schedule.
Built by engineers who have shipped 50+ payer platform implementations.

100K+ GitHub Clones
0 Security
Vulnerabilities
<1hr Production
Deployment
531 Tests,
85.93% Coverage
The Platform

Everything a health plan needs.
Nothing it doesn’t.

Production-grade infrastructure purpose-built for the intersection of legacy core systems and modern regulatory compliance.

CMS-0057-F Compliance

Complete compliance with the CMS Interoperability and Prior Authorization Rule — 18 months ahead of the January 2027 deadline. Zero external dependencies.

Multi-Clearinghouse EDI

Native connectors for Availity, Change Healthcare, Optum, and Inovalon. Failover capability, zero vendor lock-in, and full business continuity.

X12 to FHIR R4 Transformation

Automated transformation of X12 EDI transactions (270/837/278/835) to FHIR R4 resources. Real-time, bidirectional, production-tested at scale.

Core System Integration

Connects to any claims administration platform without replatforming. Extends your existing investment rather than replacing it.

HIPAA-Grade Security

BAA included. Zero known vulnerabilities. End-to-end encryption. Production-ready audit trails and compliance reporting — out of the box.

Flexible Deployment

Azure Logic Apps for rapid delivery or Kubernetes for enterprise control. Identical capabilities across both. Deploy to your own subscription.

CMS-0057-F

Compliant. 18 Months Early.

The January 2027 deadline is not a future problem. It was solved in production, now.

✓ Patient Access API ✓ Provider Access API ✓ Prior Authorization API ✓ Payer-to-Payer API ✓ Da Vinci IGs ✓ USCDI v1/v2

Transform X12 EDI (270/837/278/835) to FHIR R4 with zero external dependencies.
531 comprehensive tests. 85.93% coverage. v4.0.0 production-ready.

CMS-0057-F Compliance Guide →
Results

Real outcomes.
Anonymized. Specific.

Health plans don’t announce wins. The numbers tell the story.

Medicaid MCO

CMS Compliance Without a Core Upgrade

Regional Medicaid MCO needed CMS-0057-F compliance without an 18-month core platform replatform. Deployed in 3 weeks. Live in production with zero disruption.

<3 weeks
from first deployment to production live
  • Avoided $2M+ core platform upgrade cost
  • Live 18 months before the CMS deadline
  • Zero impact to existing claim operations
Regional Health Plan

Multi-Clearinghouse Resilience

Health plan dependent on a single clearinghouse added secondary failover capability. Zero transactions lost during a major clearinghouse outage.

100%
transaction continuity during clearinghouse outage
  • Secondary clearinghouse live in under 1 week
  • Eliminated single point of operational failure
  • Reduced EDI vendor dependency risk
Medicare Advantage

BPaaS Exit to Internal Control

Medicare Advantage plan exiting a BPaaS vendor needed internal operations capability within 6 months. Delivered ahead of schedule with full audit trail.

-64%
reduction in external vendor costs, year-over-year
  • Full ownership of integration infrastructure
  • Predictable Azure infrastructure costs
  • Internal team fully operational within 90 days
Infrastructure

Two paths.
Same destination.

Both deployment options provide identical healthcare integration capabilities. Choose based on your team’s priorities.

Azure Logic Apps

Best for: Rapid deployment, Azure-first organizations, minimal operational overhead

  • Fastest time to production (<1 hour)
  • Microsoft-managed infrastructure
  • Built-in HIPAA compliance controls
  • Lower ongoing operational overhead
  • Native Azure Logic Apps Standard

Kubernetes Multi-Cloud

Best for: Enterprise control, cloud independence, hybrid architectures

  • Deploy on Azure, AWS, or GCP
  • No cloud vendor lock-in
  • Full infrastructure ownership and control
  • Hybrid and on-premise capable
  • BSL 1.1 — bring your own environment

Both options provide identical FHIR R4, EDI, and compliance capabilities.

The Team

Built by people who’ve shipped
50+ payer implementations.

Cloud Health Office was created by a team with 25+ years of combined experience building and implementing core administration platforms at Medicaid MCOs, Medicare Advantage plans, and commercial payers. We built this because we’ve watched health plans spend $2M+ and wait 18 months for integrations that should take weeks.

Core Admin Systems

Deep expertise in health plan core administration platform implementations across all major platforms.

Clearinghouse EDI

Production integrations with every major clearinghouse in the healthcare market.

Regulatory Compliance

HIPAA, CMS-0057-F, ACA, and state-level regulatory implementations at enterprise scale.

Enterprise Cloud

Azure-native, Kubernetes-first architecture designed for production health plan operations.

Now accepting pilot deployments for select health plans in 2026.

Currently Accepting Pilot Deployments — 2026

Ready to build the integration layer
your payers already needed?

Medicaid MCOs, Medicare Advantage, and commercial payers with on-premise core systems.
Deployment in weeks, not months. Production-grade from day one.

Questions? Email sales@cloudhealthoffice.com