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Judi is not just an award-winning, secure platform; it’s the infrastructure we need to deliver the healthcare we deserve
Gain simplified and comprehensive access to key metrics and data related to claims, members, monthly and quarterly reporting, and Medicare star ratings.
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Administer and manage prior authorizations (PA) in one system. The Capital Rx team diligently sets rules for, or reviews, PAs to ensure proper decisions are made in the best interest of each member, while taking drug alternatives for cost savings into consideration.
Align benefit workflow arrangements, load over 400 unique benefit configurations in a single step, and batch upload in under 10 minutes.
Oversee the pharmacy network while keeping track of pharmacy rates and MAC and specialty lists.
Gain actuarial insights into claims data and produce deliverables for RFPs and underwriting.
Easily and efficiently manage claims and ancillary invoicing for clients.
Access data while maintaining security and ensuring seamless interoperability through Judi-generated and managed API keys.
Manage formulary ingestion to adjudication with increased efficiency, saving you precious time.
Support hours of banking and billing for TPA services through the source-of-truth eligibility management platform.
Build and manage your own reports with real-time, accurate data. Easily make changes, run reports, fix issues, and set specific parameters with a few keystrokes, and pull those reports within 90 seconds.
Seamlessly manage both inbound and outbound data for eligibility, accumulations, reporting, file delivery, and retrieval while leveraging a wide array of industry standard formats and fully configurable options in all domains.
Manage member-targeted clinical programs through Judi, reducing costs and increasing efficiency.
View claims at all levels of details and gain complete insight into PDE values, D.0 elements, and simplified adjudication explanations.
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"It is imperative for our industry to modernize our technology for the benefit of clients and patients. We evaluated several other platforms and quickly recognized that Judi represents a new industry standard.”
“As Pharmacy Benefit Manager, our expert pharmacy team at Baylor Scott & White Health Plan brings more than 35 years of experience managing all health plans. As Pharmacy Benefit Administrator, Capital Rx utilizes technology to improve drug price visibility and patient outcomes. Together, we are reimagining the administration of pharmacy benefits.”
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Connecting the healthcare ecosystem, one line of code at a time
Judi evolves faster, adapts smarter, and continuously delivers value to customers and members. See the full story of a claim on one page - regardless of claim type:
- Network information
- Overrides
- What a member paid
- And much more
The benefits of next-generation claim adjudication technology are clear for Commercial, Medicare, and Medicaid plans
One astonishingly efficient & scalable Enterprise Health Platform
- Judi centralizes all benefits-related workflows and processes in one platform, solving for the patchwork of antiquated, disparate systems that support health benefits and healthcare delivery in our country.
- Reduce errors and waste, adapt to meet new regulatory requirements, customize and configure as needed.
- Drive better outcomes at a lower cost.
Judi provides infinite scale to any payer or health plan
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Architecture
Performance
Claims Scale
Patients Scale
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Modernized Medicare & Medicaid pharmacy claims processing
Developed from the ground up to be the standard for healthcare administration, Judi is designed to enhance Medicare and Medicaid compliance, including Medicare Part D requirements. Instead of shoehorning legacy platform functionalities to meet regulatory standards, Judi’s streamlined processes and adaptable design allow for easy updates and configurations to meet changing regulatory needs.
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Choose your ideal service level
Judi is designed to support your health benefits needs, whether you’re looking for a SaaS solution to power your benefits experience, a full-service partner to manage the plan from end-to-e nd, or something in between.
Transparent Pharmacy Benefit Management for Employers
Full-Service Health Benefit Management for Employers
Enterprise Health Platform for Health Plans
AI that works where it matters most
Frequently asked questions
What is Judi, and what does it do?
Judi is our proprietary enterprise health platform designed to transform how organizations manage their health benefits.
It integrates advanced technology with intuitive features to streamline all benefits-related workflows, improve decision-making, and enhance overall health benefits administration efficiency.
How can Judi benefit my organization?
Judi empowers organizations by:
- Reducing administrative burden through automation and ease of access to information.
- Providing actionable insights via advanced analytics.
- Enhancing collaboration across teams and departments.
- Streamlining workflows to improve operational efficiency.
These benefits not only save time and resources but also enable your team to focus on delivering better care and value to plan members.
Is Judi secure? How does it protect sensitive data?
Absolutely. Judi is built with enterprise-grade security features, including robust encryption, ongoing threat monitoring, and compliance with stringent healthcare regulations such as HIPAA. Data confidentiality, integrity, and availability are at the core of everything Judi offers.
Does Judi integrate with my current systems?
Yes, Judi is designed for seamless integration with your existing software and tools. Its open, flexible architecture ensures compatibility with point solutions and other vendors’ platforms, allowing you to maintain continuity and maximize the value of your current technology investments.
Can Judi be tailored to my organization’s unique needs?
Absolutely. Judi offers customizable configurations to align with your organization’s workflows, goals, and specific challenges.
Whether it’s adapting to your reporting requirements or fine-tuning functionality, Judi evolves with you to deliver the personalized support your team needs.
How easy is it to get started with Judi?
We’ve made adopting Judi simple. Our dedicated implementation team works alongside you to ensure a smooth transition. This includes tailored onboarding, staff training, and ongoing support to ensure your organization starts seeing the value of Judi from day one.
By addressing real-world challenges with an intuitive solution, Judi enables organizations to reimagine the future of healthcare management. Discover how Judi can inspire change and drive results for your team today.
