Insurance

Protect Claims and Member Records Across Every Step of Adjudication

Health insurers process millions of claims containing detailed PHI, often routing data through multiple clearinghouses and third-party processors. Seald Healthcare applies persistent encryption to claims and member records, with granular access controls that travel with the data at every step.

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The Problem

Claims data is among the most valuable and most targeted PHI in healthcare

Health insurance claims contain a complete picture of a member's medical history, diagnoses, medications, and providers. The adjudication workflow routes this data through clearinghouses, utilization management vendors, fraud analytics platforms, and reinsurance partners before a claim is resolved.

Each stop in the adjudication chain is a separate breach risk. Clearinghouse breaches have exposed tens of millions of claims in a single incident.

Utilization management and fraud analytics vendors often require full PHI access to perform their function, but they hold data long after the claim is resolved.

State insurance regulators and CMS increasingly require payers to demonstrate granular control over member data sharing.

A breach involving claims data can expose years of medical history and create class action liability at a scale that threatens business continuity.

How Seald Healthcare Solves It

Persistent encryption that travels through every adjudication step

Seald Healthcare keeps claims and member data encrypted and policy-bound as it moves through your processing ecosystem.

Claim-Level Encryption Through Adjudication

Each claim record is encrypted at origination and remains protected through every step of the adjudication workflow. Clearinghouses and processors access only what they are authorized to see.

Role-Based Access for Processor Networks

Assign access to utilization management vendors, fraud analytics partners, and reinsurance companies by role and scope. Update or revoke permissions across all partners simultaneously when a relationship changes.

Encrypted Member Record Storage

Member records stored for eligibility verification, prior authorization, and coordination of benefits are encrypted at rest with access policies that limit exposure to each business function.

Regulatory-Ready Audit Logs

Demonstrate to CMS, state insurance departments, and your own compliance team exactly who accessed which member records, when, and from which system. Logs are cryptographically signed and cannot be altered.

Ready to protect your member data?

Encrypt claims and member records across your entire processing network.

Learn how Seald Healthcare integrates with your adjudication platform and processor network to keep PHI protected at every step.

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