Stratum Core Systems, Inc
Stratum Core Systems provides a management intelligence platform for health insurers and HMOs that connects financial accounts, source records, and investigation workflows in one place. The software enables users to trace reported cost movements or provider balance differences down to underlying paid claims, capitation, and payment registers, producing reviewable evidence packets for management decisions.
- Insurance Technology
- Data & Analytics
- Software Only
- Healthcare Technology
Funding
Founders
Founder details are not available yet.
Product
Problem
Healthcare payers, such as HMOs and insurers, often rely on reported financial comparisons that may contain baseline errors or omissions. Investigating cost movements or provider balances manually across separate spreadsheets, registers, and payment ledgers is time-consuming and leaves the review open to misinterpretation or missed evidence.
Solution
Stratum Core Systems provides a management intelligence platform that connects a financial account, source records, and investigation workflows in one place. Users can examine reported revenue, estimated healthcare costs, and the remaining amount, then follow a difference—such as an unexpected outpatient cost increase or an unresolved provider balance—into the underlying paid claims, capitation, and payment registers. The software supports both financial investigations and provider reconciliations, incorporating evidence like corrected baselines or allocated payments while preserving original records. Each investigation leads to a clear, reviewable output, such as a Word review packet that states the management finding, evidence position, and next analytical tasks.
Target Audience
Primary users are health maintenance organizations (HMOs) and health insurers that need to investigate financial pressure, validate reported cost movements, and reconcile provider balances before management reporting.
Features
- Financial account dashboard showing revenue, estimated healthcare costs, and amount remaining with a reconciled baseline and source basis
- Investigation workflows for cost movements, breaking down comparisons by health plan, service, and provider, with corrections that leave original records intact
- Provider reconciliation cases that compare provider statements, HMO records, and payment ledgers, supporting allocation of existing payments without new cash movements
- Evidence review module that tracks explicit record-check states, reconciliation completeness, and held records requiring clarification
- Downloadable Word review packets that connect a supported finding to its scope, supporting records, and remaining open checks for management review
- Health-plan views that separate paid claims, allocated capitation, and unpaid estimates, with allocation assumptions and unassigned amounts kept visible