Optimized care & protection

Rulesware streamlines healthcare insurance with cost-effective solutions, automating enrollment, claims, and authorizations. Boost performance and enhance customer experience through personalization and digital efficiencies.


Sophisticated Group Quoting

Enhanced group quoting isn’t just a perk—it can be a game-changer for healthcare software companiesLet us show you. 


Optimized & Connected Provider Networks


Advanced Enrollment


Autonomous Claims Handling


Automated Care Management


Optimized Call Center Operations


AI Driven Back Office


Better Business Outcomes


Optimized Architecture

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- Fin Service Client



Rulesware assists our clients in streamlining their group quoting process, starting from the initial briefing and extending through approval, distribution, and monitoring. Establishing a standardized process is crucial for ensuring transparency, accuracy, collaboration, and timeliness. Managing transparency during the drafting, revising, and finalizing stages of the quote requires specialized handling and processing. Utilizing technologies and processes that seamlessly integrate with policy administration systems is highly recommended for optimal efficiency.


Success STORY

End-to-End Group Quoting Process

A payment processing client needed a global contact center and disputes application for handling transactions while navigating financial compliance rules from more than 100 countries.



We help you specialize in optimizing provider networks through innovative technology and strategic partnerships. Our solutions leverage data analytics to help identify high-performing providers, negotiate favorable contracts, and enhance network efficiency. We also have experience and offer tools for provider credentialing, performance monitoring, and network expansion.  

We help our clients manage costs and maximize the value delivered to their members and providers. This strategic approach grants them a competitive edge in the market. 


Success STORY

Not-For-Profit Health Insurance Company

Transformation of expensive, unscalable, error-intensive manual processes with digital automation in order to strengthen their relationships with their Provider network(s).



Rulesware is at the forefront of the industry in Pega Enrollment Implementations, enabling you to accelerate enrollment processes for your end users. 

We enhance profitability and operational flexibility for forward-thinking enterprises. Leveraging our expertise, we optimize enrollment procedures, design engaging customer journeys, and deploy cutting-edge automation solutions, allowing you to prioritize what’s essential for your members. 

Empower your customers with state-of-the-art digital tools customized to address their insurance requirements in today’s competitive markets, ensuring sustained business growth and expansion both presently and in the future.


Success STORY

Medicaid Enrollment Automation Streamlines The Member Journey

Overcoming the challenges of an efficient, customer-centric enrollment for Medicaid.


Claims Handling

We have helped many of our healthcare clients manage and optimize their claims processes in order to help reduce their claims costs and leakage due to improper claims adjudication.   

At Rulesware, we offer cutting-edge automated claims processing services and solutions designed to expedite the entire claims lifecycle. 

Our advanced technology automates tedious tasks such as: claim submission, verification, adjudication, repair, payment processing, and error minimization. With our solutions, you’ll experience faster claims resolution, reduced administrative burden, and improved accuracy, ultimately enhancing your bottom line. 


Success STORY

Pharmacy Claims Processing

Intake automation for a pharmacy client whose primary business was processing claims for health insurers, employers, individuals and seniors on Medicaid.


Care Management

At Rulesware, we specialize in helping Healthcare organizations implement care management automation solutions designed to streamline care coordination, enhance patient engagement, and improve care quality. Our solutions help you integrate with electronic health records (EHRs), population health management systems, and other healthcare IT systems to provide a holistic view of patient health and care history. With automated workflows, proactive alerts, and analytics capabilities, our solutions have empowered care teams the ability to deliver personalized, evidence-based care while maximizing efficiency and resource utilization.


Success STORY

Non-Profit Care Management Services

Managing manual processes for a non-profit organization providing professional care services and financial assistance to patients, with serious health conditions.


CALL CENTER operations

At Rulesware, our expertise lies in crafting cutting-edge applications tailored for call centers. We prioritize the development of intelligent call routing systems and seamless integration with CRM platforms. Our solutions equip agents with extensive customer data and history, facilitating personalized interactions and swift issue resolution. Additionally, they establish a robust framework for transparent and timely handling and management of service cases. 

The best call centers have Pega, and have been implemented by Rulesware – let us show you. 


Success STORY

Health Insurance and Pega Re-Architecture

After investing in Pega and two years of work, a US-based health insurer enlisted Rulesware to upgrade and re-architect their call center solution.

AI Driven


At Rulesware, we recognize that efficient back-office operations and automation within it are crucial for achieving overall business success. That’s why we provide cutting-edge back-office automation services tailored to streamline your administrative processes and supercharge productivity. 

Our advanced technology automates repetitive tasks, optimizing workflows, and eliminating manual errors. With our back-office services, you’ll experience increased efficiency, enhanced accuracy, improved scalability, and significant cost savings. 

Let us revolutionize your back-office operations and propel your business to new heights of success. Partner with Rulesware and unleash the full potential of your system applicators.






Success STORY

Onboarding Fallouts & Handling.

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We take pride in delivering the best business outcomes for our clients through our engagements. Whatever your problem areas or needs may be, we’ll work with you to define targets and execute strategies to meet them. Our commitment extends to measuring progress against results, providing you with peace of mind that you’re achieving the outcomes you expect. 

With Rulesware you get optimal delivery of your solutions with enhanced effectiveness and efficiency in processes, resulting in superior business outcomes. 


Success STORY

Rulesware's Pega Expertise Takes Palomar Growth to the Next Level

Client was not deeply experienced with Pega, was on the other side of the globe, and was providing code that wasn’t up to their high standards. 



At Rulesware, we are dedicated to developing top-notch applications for our clients, utilizing the right architecture and design to guarantee consistent, dependable performance, even during idle periods. We’ve supported healthcare organizations in transitioning to cutting-edge architectures that directly enhance and optimize performance, scalability, and security. 

Our teams possess a deep understanding of application design and its interplay with infrastructure, allowing us to optimize both elements for seamless integration. We have a proven track record of assisting our clients in achieving optimal application uptime and resilience, and we’re ready to extend our expertise to help you achieve the same. 


Success STORY

Health Insurance and Pega Re-Architecture

After investing in Pega and two years of work, a US-based health insurer enlisted Rulesware to upgrade and re-architect their call center solution.

Want to know how we can help your business?