Top 10 New Judi® Updates Improving Health Benefits Administration
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The work happening at Judi Health across our platform, Judi®, is shaped by how health benefits are administered and experienced.
Our team’s focus on strengthening the platform comes through close collaboration with the people who rely on it, paying careful attention to how claims are reviewed, how prior authorizations move through the system, and how members interact with their benefits, reflect our continued commitment to building technology that supports clearer workflows and more informed decisions throughout healthcare claims administration.
Here are the latest capabilities now available in Judi, with perspectives from the team members closest to the work, and how they fit together to support a more connected and transparent approach to managing health benefits.
1. Prior Authorization Visibility and Decision Support
Prior authorization plays a central role in how care decisions move forward, with members, providers, and administrative teams all being involved at different moments throughout the process. Judi brings together request status, documentation review, and decision support within a single workflow, so information doesn’t live across disconnected systems.
AI assistance organizes incoming documentation, routes materials to appropriate cases, and supports approvals when clinical criteria are met, keeping reviews on track without added delays.
Why it Matters: Lorece Shaw, Director of Clinical Client Operations
"It’s easy to forget how confusing and stressful the prior authorization process can feel from the member’s point of view,” says Lorece. When access to care is on the line, members deserve transparency and timely decisions, and providers shouldn't have to rely on phone calls or fragmented systems to move care forward. Having a single place to see where a request stands, what’s needed, and submit supporting documentation makes a difference in those moments.
From an operational standpoint, the biggest impact comes from having the full member picture in one place. When review teams can see claims history, benefit setup, and run test claims directly in the system, reviews move faster and with greater clarity. Judi’s AI surfaces the most relevant clinical information in context, so reviewers spend less time hunting through notes and more time making sound clinical decisions.
For plans using Judi, Lorece says, “Decisions affecting members are being made thoughtfully, with full context, and with access to care at the center of the process.” For plan sponsors, transparency is a member benefit, creating fewer escalations, complaints, and a prior authorization process that holds up under scrutiny.
2. Unified Medical, Pharmacy, Vision, and Dental Claims Processing
Judi supports medical, pharmacy, vision, and dental claims processing within a single platform, allowing teams to work with a more complete view of benefit activity. Keeping claims in one environment helps administrators maintain context as they review activity across the benefit types and supports consistency in how information is accessed and understood throughout the claims process.
Why it Matters: Mark Pearce, Director, TPA Operations
When medical and pharmacy benefits live on separate platforms, the cracks show up in places members feel directly. Mark points out that split systems mean accumulators can fall out of sync, leading to claims being adjudicated against stale data and adjustments that change what members owe after the fact. A unified platform eliminates that lag. One ID, one phone number, one portal for pharmacy, medical, dental, and vision information, and fewer surprises when the bill arrives.
For plan sponsors, the operational case is just as clear. One system means no data reconciliation across platforms, support teams that can answer member questions on the first call, and reporting that shows medical and pharmacy utilization side by side. “When a member or provider calls, our care team has a full view into the full history of that member,” Mark explains. The continuity extends to reporting as well, giving plan administrators a side-by-side view of medical and pharmacy utilization, cost, and benefit performance, making Judi a single environment for the full benefit picture.
3. Identity and Access Management Enhancements
As organizations evolve, managing access within systems requires ongoing attention. Enhancements to Judi’s Identity and Access Management module give administrators clearer insight into how users are grouped and how permissions are applied, supporting thoughtful access control as teams grow and change.
Why it Matters: Jillian Lonson, PMP®, VP of Benefit Administration Operations
In benefits administration, access complexity builds fast. As organizations grow and teams change, permissions can quietly drift out of alignment with job functions. Jillian explains that administrators need a clear picture of who has access and what to manage sensitive employee and member data appropriately. Better visibility into user groups and permissions makes access decisions more intentional and reduces risk over time.
As responsibilities shift, these enhancements help ensure access stays aligned without adding to administrative burden. In Jillian’s words, “It’s a practical improvement that helps clients scale while maintaining confidence in the security and integrity of their data.”
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4. Test Claims Adjudication Redesign
Before a plan goes live, teams need confidence in how claims will be processed. Judi’s Test Adjudication Module supports this preparation by allowing simulated pharmacy transactions and close examination of claim behavior, helping teams validate configurations during implementation.
Why it matters: Jeff Brockner, Senior Manager of Customer Success, Technology
“Testing is my stay out of jail card,” says Jeff, and that’s not hyperbole. For health plans, Medicare non-compliance can mean civil monetary penalties, legal action, or termination from the program entirely.
Judi’s test adjudication redesign gives teams the ability to catch and resolve issues early, validate that claim outcomes meet expectation, and build confidence in the system before members are affected. It also gives teams time to get comfortable with how the system behaves before anyone’s claim depends on it.
5. A Healthcare Portal for Providers that Adds Value
Clear communication between providers and administrators plays an important role in care coordination. The Healthcare Portal allows pharmacies and prescribers to submit prior authorization requests, track progress, and share documentation within a single experience designed to align with provider workflows.
Why it matters: Jocelyn Smith, Manager, Clinical PA Technician
Jocelyn has seen what happens when prior authorization communication falls through the cracks. A provider calls in an authorization; clinical notes arrive by fax separately, and if those pieces don’t connect in time, the request can move to determination before the documentation even lands. “When access to care is on the line, members deserve transparency and timely decisions,” she says.
Providers shouldn’t have to rely on phone calls or fragmented systems just to move care forward. By centralizing submissions, status tracking, and documentation in a single workflow, Judi reduces delays, eliminates unnecessary follow-ups, and gives providers clear visibility into next steps.
The result, as Jocelyn puts it, is the clarity teams need to “act faster, coordinate more effectively, and keep patient care moving without disruption.”
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6. Accumulation History Visibility
Access to accurate accumulation data (e.g., how much a plan member has spent year-to-date under the deductible) supports better understanding of benefit usage. Judi provides a consolidated view of accumulation history with flexible filtering options, helping teams respond to questions and manage benefits with greater confidence.
Why it matters: Jake Mulkey, Director of Product Technology
Accumulation history is one of the harder areas of pharmacy claims to track, and visibility into it matters when dollars are on the line. Jake explains that when a member believes they’re being overcharged, care teams and plan administrators need to pull up the full picture fast and explain exactly where that member stands. Without that clarity, resolving disputes is slow, uncertain, and frustrating for everyone involved.
“This visibility helps plans ensure accuracy and recover dollars where members may be spending more than they should,” says Jake. With Judi storing accumulation data alongside medical information, teams can account for combined spend across a member’s full plan and work accurately with their medical accumulations vendor. As Jake frames it “all of this starts with having a concise, holistic view of a member’s spend throughout their plan year.”
7. AI-Powered Clinical Criteria Review
Clinical criteria review requires careful interpretation and consistency. Judi’s AI-Powered support extracts relevant information from submitted documentation and provides rationale that updates as new information is introduced during the review process.
Why it matters: Kobby Ayite, Director of Product Technology
"The prior authorization landscape demands speed, precision, and transparency,” says Kobby. By extracting and analyzing submitted information against client-specific clinical criteria as reviews happen, Judi’s AI-powered support completely transforms what has historically been a manual, time-intensive process.
Shorter review cycles and improved decision accuracy mean less administrative burden on clinicians and a process that doesn’t bottleneck as case volume grows. For patients, Kobby says, “this translates to faster access to care.”
8. Member Activity Dashboard
Supporting members effectively depends on having clear access to information. The Member Activity Dashboard brings relevant members’ data into one view, allowing plan sponsors and our member care teams to move through support interactions with continuity and context.
Why it matters: Chris Olsen, Business Analyst
When support teams don’t have a consolidated view of member activity, finding answers means jumping between individual pages to piece together the full picture. Chris explains that the Member Activity Dashboard changes that by bringing benefits usage, claims history, prior authorizations, eligibility changes, and accumulation data into a single view.
“This consolidated page makes it easier for plan sponsors to see a holistic view of how each member is using their benefit,” Chris notes, allowing support teams to quickly diagnose where an issue stems from without the back and forth.
9. Spanish-Language Member and Enrollment Portals
Language plays an important role in how members engage with their benefits. Spanish-language versions of the Member and Enrollment Portals allow members to navigate enrollment and benefit information in language they are most comfortable using, supporting clearer communication throughout their experience.
Why it Matters: Colleen Staunton, Product Technology Manager
For health plans serving Spanish-speaking members, language access is a compliance issue as much as it is a member experience one. CMS’s 2024 translation requirements set a clear standard, and meeting it means more than checking a box.
“Non-English-speaking members can now self-serve through open enrollment and ongoing benefits navigation where they previously couldn’t,” says Colleen Staunton, Manager of Product Technology, “This eliminates the need for translators and to help them navigate the process.”
Judi’s Spanish-language abilities give plans fewer points of friction, better engagement, and a clearer path to meeting regulatory requirements without adding operational burden.
10. Historical Prior Authorization Data Exchange
During implementation, access to historical information supports continuity. Judi’s Data Exchange Module allows prior authorizations from an incumbent PBM to be imported into the platform, preserving context while reducing manual effort during transitions.
Why it matters: Amit Shah, Director of Data Exchange Technology
“The biggest risk a plan sponsor takes when switching PBMs without transferring historical PA data is loss of continuity of care,” says Amit. Without it, members may face rejected claims, care interruptions, and delays from having to restart the prior authorization process entirely, often resulting in dissatisfaction and increased HR escalations.
Carrying existing approvals forward prevents those disruptions and eliminates appeals that would not have come up had the data transferred cleanly. Amit adds that “this data supports uninterrupted specialty treatment,” which for plan sponsors also means accurate accumulator tracking for high-cost medications and a reliable baseline for utilization management from day one.
Where the Work is Headed
Each of the highlighted updates reflects what our team hears consistently from the plans, providers, and members who rely on Judi every day. The problems are real, the stakes are high, and the work of building technology that helps people navigate healthcare doesn’t stop here.
As Judi continues to evolve, the focus stays the same: making health benefits administration clearer, faster, and more accountable for everyone in the system.
Curious how these updates come together in Judi? Explore the platform or connect with our team to learn more about how we support your plan.
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