Claims, Eligibility, Policy, and Member Data — Automated
Vorro's integration platform handles the complex, high-volume data flows that define insurance operations — from real-time eligibility verification to policy lifecycle management to claims processing.
Built for Every Part of Your Organization
One platform. Multiple entry points. Purpose-built for each team's specific integration needs.
Claims Processing & Automation
Automate claims intake, adjudication, and payment workflows using EDI X12 837/835 and modern API-based integration — reducing manual processing time and error rates.
- EDI X12 837P/I/D claims processing
- ERA/EFT 835 payment automation
- Claims scrubbing and validation rules
- Denial root cause classification and routing
Eligibility & Benefits Verification
Real-time eligibility checks against 250+ payers and health plans — using EDI 270/271 and FHIR R4 APIs — reducing manual verification calls by up to 80%.
Learn MorePolicy & Member Lifecycle Management
Connect your policy administration systems, CRM, and member portals into a unified data layer — with event-driven automation for enrollments, renewals, and changes.
- Policy administration system connectors
- Member enrollment and disenrollment events
- Life event trigger automation
- Agent and broker portal data sync
Regulatory Reporting & Compliance
Automate state and federal reporting requirements — from CMS encounter data submissions to state DOI filings — with full audit trail and error resolution workflows.
- CMS encounter data submission pipelines
- EDGE server data integration
- Risk adjustment data management
- State regulatory reporting automation
