CMS-0057-F Mandate
The CMS Interoperability and Prior Authorization final rule requires health plans to implement FHIR-based prior auth APIs. Existing CAPS vendors are slow to deliver compliant modules — and charge a premium when they do.
Open-Source Healthcare Payer Infrastructure
Aurelianware builds the vendor-neutral compliance and operations layer that deploys alongside your existing core admin system — QNXT, Facets, HealthEdge, or any other CAPS.
The Problem
A single vendor bought control of the et and independent implementation partners were displaced overnight. Health plans found themselves captive to a this vendor's roadmap, pricing, and compliance timeline.
The CMS Interoperability and Prior Authorization final rule requires health plans to implement FHIR-based prior auth APIs. Existing CAPS vendors are slow to deliver compliant modules — and charge a premium when they do.
Adding interoperability shouldn't mean replacing your entire claims adjudication system. Yet that's exactly what most vendors demand — a multi-year, multi-million dollar rip-and-replace.
Hundreds of experienced TriZetto implementation consultants lost access to the platform they built their careers on. Their expertise has no home in the Cognizant-controlled ecosystem.
Closed-source payer systems move at the vendor's pace, not yours. Feature requests take years. Bug fixes take months. And you pay for every change order.
Product Suite
Every Aurelianware product is designed to sit alongside — not replace — your existing systems. Licensed under BSL 1.1 for transparent, predictable access.
The only vendor-neutral CMS-0057-F compliance layer deployable alongside any core administrative processing system. Prior authorization, appeals, member portals, provider directories, and more — all FHIR R4 native.
Privacy-first security monitoring and AI inference platform. On-device processing with ONNX Runtime — your data never leaves your infrastructure.
Microservices-based dental practice management platform with 837D claim pipeline, OCR integration, and a strangler fig migration path from legacy monoliths.
Privacy-first vehicle surveillance integrating Raspberry Pi 5 with Tesla hardware and PrivaseeAI for on-device AI inference. Zero cloud dependency for video processing.
Architecture
The ICoreAdminAdapter pattern lets Cloud Health Office integrate with any CAPS without rewriting your adjudication logic.
Pricing
No opaque licensing. No surprise change orders. Predictable per-member, per-month pricing that scales with your plan.
Get Started
Whether you're a health plan looking for CMS-0057-F compliance or an implementation partner seeking a new platform — let's talk.