CMS chooses finalists for Medicare claims processing competition

▤ Summary

CMS has narrowed its Medicare claims processing competition to two finalists: HealthEdge Software and Peraton. The agency will run prototype demonstrations and challenge-based evaluations before naming a single integrator for the ClaimsCore program. ClaimsCore aims to replace four legacy systems built in the 1970s and support more than 2 million users while processing over 100,000 claims per day. The effort carries major long-term contract value and centers on modernization, interoperability, scalability, and payment integrity.

▦ Linked Companies

HealthEdge

$100M to $250M