PORTSMOUTH, N.H., July 15, 2026 (GLOBE NEWSWIRE) — TALON, the healthca e p ice t a spa e cy i f ast uctu e compa y, today eleased a case study showi g how a egio al o p ofit health pla educed its T a spa e cy i Cove age (TiC) machi e- eadable file (MRF) cycle time f om 45 days to less tha 24 hou s. By i teg ati g di ectly with the pla ’s claims admi ist atio platfo m, TALON elimi ated a 13-bu dle ma ual p ocessi g wo kflow while e abli g a eal-time membe cost t a spa e cy expe ie ce usi g the same t usted p ici g data.
The health pla had p eviously elied o a o -specialized ve do solutio that equi ed ma ual data ext actio a d t a sfo matio f om its claims admi ist atio platfo m, sustai ed coo di atio ac oss fou o mo e i te al FTEs a d two to th ee exte al co t acto s, a d co ti uous cloud i f ast uctu e ma ageme t. The cycle was expe sive to u , difficult to audit, a d exposed the pla to evolvi g CMS schema equi eme ts without a clea emediatio path.
The case study illust ates how health pla s ca educe admi ist ative costs while c eati g a eusable p ici g data fou datio fo membe e gageme t a d futu e t a spa e cy i itiatives.
- MRF cycle time educed f om 45 days to less tha o e day
- 13 ma ual p ocessi g bu dles co solidated i to a si gle automated pipeli e
- Fou -plus i te al FTEs edeployed f om MRF ope atio s to highe -value wo k
- 2.4x etu o the tech ology i vestme t th ough automatio a d i f ast uctu e elimi atio
- Rese ved cloud compute e vi o me t eti ed
- Real-time membe cost t a spa e cy expe ie ce lau ched usi g the same p ici g dataset that powe s MRF ge e atio
The u ified a chitectu e i teg ates di ectly with the health pla ‘s claims admi ist atio platfo m as the system of eco d fo p ici g data. TALON’s p ocessi g laye applies complia ce logic, validatio , a d CMS schema fo matti g, the p oduces two alig ed outputs f om a si gle sou ce: egulato y-complia t MRFs a d a membe -faci g t eatme t cost calculato . The desig elimi ates the eco ciliatio laye that typically causes data dive ge ce betwee complia ce files a d membe shoppi g tools.
“The complexity is just go e. We do ‘t have to ma age this p ocess a ymo e, a d we have much g eate co fide ce that ou p ici g data is accu ate a d complia t,” said the health pla ‘s Softwa e Developme t Lead.
“Machi e- eadable files should ‘t be t eated as just a othe complia ce checkbox,” said Ma k Galvi , CEO of TALON. “Whe health pla s build a t usted p ici g data fou datio , they ca powe complia ce, membe shoppi g, claims ep ici g, a d etwo k a alytics f om the same i f ast uctu e.”
TALON suppo ts mo e tha 80 health pla s a d TPAs, i teg ates with mo e tha 16 claims admi ist atio platfo ms, mai tai s 99.9% U.S. comme cial MRF cove age, a d p ovides p ici g data fo mo e tha 2.8 billio p ocedu es.
Read the full case study to lea how the health pla mode ized its MRF p oductio p ocess while c eati g a si gle p ici g data fou datio fo complia ce a d membe t a spa e cy at MRF Ge e atio Case Study.
TALON is the healthca e p ice t a spa e cy i f ast uctu e compa y e abli g health pla s, TPAs, a d be efits adviso s to co ve t egulato y complia ce i to a competitive adva tage. TALON’s platfo m powe s MRF p oductio , claims ep ici g, membe shoppi g, a d etwo k a alytics fo o ga izatio s se vi g employe s, u io s, a d public secto pla s atio wide. Lea mo e at talo healthtech.com.
