Portal hub and domain routing
Users start from a clear public hub, then move into the secure portal that matches their role.
Phoenix Health Platform
A connected operating layer for modern healthcare administration.
Phoenix connects document intake, coverage validation, clinical policy signals, benefit rules, enrollment, reporting, and portal collaboration through one governed operating model.Portal separation Governed workflow Audit evidence
Platform model
Operational clarity from intake to audit.
Phoenix is built for TPA operations where claims, members, providers, employers, documents, policies, and reports must stay connected without exposing internal records on the public website.
- 01 Document intake
Source documents enter a controlled workflow and are classified before extraction starts.
- 02 OCR and normalization
AI-assisted normalization maps extracted content to professional operational field labels.
- 03 Eligibility validation
Coverage, policy period, group, plan, and member status are checked before the workflow proceeds.
- 04 Clinical and policy review
Clinical pathway, coding, modifier, place-of-service, and policy rules produce governed signals.
- 05 Adjudication engine
Configured plan design and benefit rules drive calculated outcomes and exception queues.
- 06 Payment and EOB/ERA
Approved outcomes move into payment candidate, remittance, EOB, and ERA communication controls.
- 07 Reporting and audit
Operational reports, secure exports, audit evidence, and compliance traceability stay connected.
System architecture
Core modules work as one operational fabric.
Portfolio pages show the platform architecture at a feature level: portals, source documents, rules, queues, evidence, and reporting stay connected without turning the website into an operations console.
Claims, coverage, policy, and enrollment
Document intake, eligibility, plan rules, provider context, and enrollment changes stay connected.
Evidence, reporting, and release gates
Operational proof is captured through audit trails, report runs, health checks, and release evidence.
Capability
Claims Automation
OCR intake, AI-assisted normalization, eligibility validation, clinical pathway review, and payment handoff.
- Document intake
- Coverage validation
- Clinical pathway signals
Capability
Enrollment and ID Cards
Employer census intake, plan linkage, coverage maintenance, ID-card templates, and bulk generation workflow.
- Census workflow
- Coverage setup
- ID-card production
Capability
Provider Network
Provider setup, network access, contract visibility, fee schedule governance, and provider portal handoff.
- Network operations
- Contract controls
- Portal access
Capability
Reporting and Compliance
Operational reports, audit evidence, secure exports, role-based visibility, and compliance-ready traceability.
- Report runs
- Audit evidence
- Secure exports