Claims moved between payers and providers faster, rejection rates at the format level dropped, and transaction dashboards improved — yet the enterprise structure linking provider data management, policy adjudication, payment integrity, fraud detection, and regulatory reporting was never modeled.
While portals improved customer-facing processes (P2) and component usability (P4), our analysis found deep integration gaps in system behavior (P3) and missing governance alignment from strategy (P1) through operations (P6).
