Eligibility and Claims

Eligibility and claims applications contain many complex rules, with more piling daily.

Batch Rule Execution Illustration

Your Challenge

With complex business rules being hard coded into your apps, changing, testing, and deploying eligibility and claim rules can cost a software developer multiple productive hours, if not days or weeks.

The most crucial steps are simplifying and enhancing the current claim-routing procedure to ensure that it complies with all current insurance and healthcare laws and regulations.

How Corticon Helps

Improve the accuracy and speed of benefits, eligibility and delivery for your customers. For example, a mortgage company can use Corticon to determine the programs and rates a customer qualifies for. Whether it’s healthcare, banking, state benefits – Corticon assists you in keeping up with rapidly changing eligibility.


Increase decision consistency and accuracy across a high volume of transactions for routine tasks like policy underwriting and claims processing, independently of their applications.

Removing unnecessary manual steps in processes with recurring decisions can speed those processes, reduce costs and increase customer satisfaction.

Automate and manage change in product eligibility rules.


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