PBM claims platforms, modernized without stopping the claims.
Legacy claims-testing and adjudication-support systems re-platformed to cloud-native microservices — with the compliance strengthened, not traded away for speed. Delivered for large PBM organizations, by the practitioners who scoped the work.
The problem we keep meeting
PBM platforms age in a specific way: a business-critical .NET monolith that has become hard to maintain and expensive to change, no CI/CD so every release is a project, claims files still moved by hand, and transaction volumes climbing past what the architecture was sized for. Nobody can pause adjudication to fix any of it — the modernization has to happen while the claims keep flowing.
What we actually do
Re-platform to microservices, incrementally
Legacy .NET re-architected to Java microservices on AWS (ECS, RDS, S3, Lambda) — modules scale and change independently, integrated with the legacy platform through REST APIs while it still runs.
Build the delivery pipeline in
Automated regression testing and CI/CD built into the platform itself, so releases stop being events.
Automate the claims-file plumbing
Managed file transfer with AES-256 at rest, TLS in transit, role-based access and complete audit trails — manual movement of pharmacy claims files eliminated.
Partner-framed compliance
HIPAA and HRSA alignment designed into the build. We bring the engineering; your team brings the pharmacy-benefit domain — we don't pretend to know your business better than you do.
What this has produced
concurrent users and test executions on a re-platformed claims-testing system
transaction capacity on a re-architected 340B platform
of daily and monthly pharmacy claims transfers automated
Every number above is a delivered result from PBM and pharmacy-technology engagements — not a projection or an industry benchmark.
Questions buyers actually ask
Can a PBM claims platform be modernized without interrupting adjudication?
Yes — that constraint shapes the whole approach. We re-platform incrementally: the legacy system keeps running while modules move to microservices one at a time, integrated through REST APIs. In our PBM engagements the business kept processing claims throughout; there was no cutover big-bang.
What does a PBM modernization typically involve technically?
In our delivered work: legacy .NET re-architected to Java microservices on AWS (ECS, RDS, S3, Lambda), automated regression testing and CI/CD pipelines built into the platform, REST integration with the legacy claims platform and third-party pricing and compliance services, and managed, audited file transfer replacing manual claims-file movement.
How is HIPAA handled during a re-platform?
Compliance is designed into the build rather than audited on at the end — encryption at rest and in transit, role-based access control, automated audit logging, and for 340B work, automated duplicate-discount detection and Medicaid Exclusion File validation. On one 340B re-platform, HRSA and HIPAA compliance came out strengthened, not merely preserved.
Do you know the PBM business, or just the technology?
Our depth is the engineering — claims systems, adjudication-support platforms, 340B, pharmacy data. We work alongside the client's own pharmacy-benefit experts rather than claiming their domain: we bring the technology, you bring the domain. That division of labor is deliberate and it's why the engagements work.
How do we start without committing a budget?
Bring us the actual problem — the system, the volumes, the constraint. We assess it free, and for the right fit we build a working prototype before any invoice. If it earns your confidence, the same practitioners who scoped it stay and take it to production.
Let's prove it — on a problem of yours.
Bring one real problem. We assess it free — and for the right fit, build a working prototype. No invoice until you decide to take it to production.