a Modern Platform

For Medicare and Medicaid Claims Processing

Leave behind the headaches and struggles of legacy platforms with JUDI® as your independent and aligned Medicare and Medicaid backend processing engine.

The industry standard for Medicare backend claims processing.

JUDI is the industry’s first cloud-native enterprise pharmacy platform that unifies all PBM operations onto a single platform. You offer the plan. JUDI will give you the power to deliver the most accurate, secure, and efficient operation possible.

Have you tried to use a typewriter to write code for a software application?

Yeah, you can’t.

It’s the same for legacy claims processing systems. These systems were not designed with the latest government requirements in mind and often must shoehorn their functionality to meet regulatory standards. This can result in errors, fines, and a suboptimal patient experience. But with JUDI, you can leave these frustrations behind. JUDI was built from the ground up, after Medicare Part D, to handle Medicare and Medicaid claims processing requirements, so there's no need to worry about bending outdated systems to meet regulatory standards.  

Want to see an example?
Time is the most valuable thing you can spend.

Built after Medicare Part D, JUDI empowers you to save hundreds of hours on administrative tasks, so you can focus on what matters. No more waiting weeks for a formulary update or spending hours running batch tests. With JUDI, you can update your formulary in a pinch and test 1,500 claim scenarios in minutes - a fraction of the time it takes legacy platforms.

Life’s easier when systems talk.

Gone are the days of struggling with complex data exchange and integration issues.

Take advantage of JUDI's ability to service over 180M lives with a single instance, saving time and resources.  JUDI was developed using an Open API Architecture, making data exchange for accumulators and eligibility extremely easy. Our platform streamlines your operations and allows for seamless interoperability, incorporating into your existing benefits management processes.  Point solutions are extremely easy to integrate, enabling users to leverage JUDI's functionality without the need for significant modifications to existing infrastructure. JUDI's instance deployment time is compressed from over a year to just an afternoon, allowing for rapid resource development for new customers.

Read how we helped a client with API Integration.

Never feel restricted

by rigid and inflexible systems.

It's important to have flexibility and control of your Medicare plans. That’s why we support full-service and modular strategies designed to meet your evolving needs. JUDI's modular platform offers customizable options for systems and services such as claim processing, data exchange, Prior Authorization (PA) tools, patient tools, implementation, underwriting, call center, and clinical services. With JUDI, you can select the right mix of services and technology to meet your unique needs.

Simple pricing, no hidden costs.

JUDI gives you transparency and control to keep your costs in check.

Managing your costs can be a challenge, especially when hidden fees and costs are lurking around every corner. With JUDI's ability to administer transparent pricing, you'll never have to worry about hidden admin costs.

Carriers and plans can manage their economics directly or use our transparent network and rebate agreements without any cost or performance fees. Full financial alignment is a shared goal.

Security & Compliance.

It’s top of mind.

JUDI is compliant with state and federal regulations from day one.  Your sensitive healthcare data is one of your most valuable assets. We understand that, which is why our top priority is ensuring the security of it.  Ensure that only the right people can access your company’s data in JUDI with our sign-on (SSO) and granular data access permissions.

JUDI is 100% developed and serviced in the USA, adhering to the strictest standards for protecting sensitive information.

We do more

than read a CMS checklist.

Health plans deserve a consultative, trustworthy partner.  We go beyond the “check box” of CMS requirements to drive a better member experience and improved health outcomes for members.  

Through JUDI, health plans of all sizes have access to intuitive tools like PDE and Star Ratings dashboards for real-time data to proactively manage prescription drug events and meet STARS Ratings objectives.

stars rating dashboard medicare
capital rx founders

Revolutionize your Medicare & Medicaid backend claims processing with JUDI.

Give your clients the flexibility and power to reduce their drug spend with Capital Rx.