The Problem
Claims Data Contains the Full Patient Story
Claims and member records contain diagnoses, medications, procedures, providers, eligibility information, payment history, and years of medical activity. A single claims dataset can reveal more about a patient than almost any other healthcare record.
Every Adjudication Stop Is a Risk
Each X12 claim, eligibility transaction, prior authorization request, clearinghouse exchange, utilization management review, and processor workflow creates another location where PHI can be stored, copied, or exposed.
Vendors Retain Excess PHI
Utilization management vendors, fraud analytics partners, billing vendors, and processor networks often require broad PHI access to perform their function, then retain that data long after the original transaction is complete.
AI Is Entering Claims Workflows
Claims, prior authorization, and fraud review increasingly run through AI agents and automated tools. Each one acts with its own credentials and can reach plaintext member data.
Policies in Action
Examples of What You Can Enforce
Claims and member data moves across adjudication, utilization management, fraud review, clearinghouses, processors, PBMs, and reinsurance workflows. Seald Healthcare turns internal governance and contractual access requirements into record-level decryption policy. Start inside the payer, then extend the same controls across the processing network.
Learn More About Policy StudioDana Brooks, RN ([email protected]) can decrypt prior authorization cases in her assigned queue only, weekdays 9:00 AM to 5:00 PM Eastern, from a managed device on the plan's IP range with MFA verified. Cases outside her queue do not decrypt.
Case managers can decrypt only members assigned to their queue, during business hours, from authorized US locations.
Fraud investigators can decrypt records only for the cases assigned to them. Records outside their caseload do not decrypt.
Member Social Security numbers decrypt only for the enrollment role.
Irongate Reinsurance can decrypt the authorized claims extract only, from its registered environment on the approved IP range, with MFA verified, for 30 days. Access expires automatically at the end of that period.
Beacon Analytics can decrypt only the fields authorized for its workflow. Member identifiers do not decrypt in its environment.
Wexford Clearinghouse is limited to five record decryptions per 30 minutes, and forwarded records do not decrypt for unauthorized recipients.
Sable Utilization Review's access is revoked automatically when its engagement ends.
HIPAA Safe Harbor
A Breach of Properly Encrypted PHI Is Not a Reportable Breach Per HHS
If protected health information is lost, stolen, or accessed by an unauthorized party, properly encrypted data remains unreadable and unusable. Under HHS guidance, properly encrypted PHI is not considered unsecured PHI when the decryption key or process has not also been compromised, and therefore does not trigger HIPAA breach-notification requirements. That means a security incident does not automatically become a reportable breach. The result can be reduced breach liability, lower cyber insurance costs, and a dramatically different outcome for your organization.
“Protected health information (PHI) is rendered unusable, unreadable, or indecipherable to unauthorized individuals if one or more of the following applies: electronic PHI has been encrypted as specified in the HIPAA Security Rule… such encryption renders the breach notification provisions of the HITECH Act inapplicable.”
No Public Disclosure
No 60-day notification clock, no HHS portal listing, no press release.
Reduced OCR Exposure
Demonstrated safeguards reduce regulatory and enforcement exposure.
Lower Insurance Premiums
Seald Healthcare’s demonstrable controls may qualify for carrier premium credits.
FAQ
Frequently Asked Questions
What does Seald Healthcare do?
Seald Healthcare protects patient data itself, not just the systems around it. Each record is encrypted individually, with decryption authority kept separate from the data. Records stay encrypted wherever they are stored, accessed, or shared and decrypt only during authorized use under policy for an approved person, device, application, or AI agent.
What does zero-knowledge mean?
Seald Healthcare manages key infrastructure separately from the patient data, but cannot independently decrypt customer PHI. Each data key is protected under key material controlled by your organization, keeping decryption authority separate from the systems storing or transmitting the data.
What happens if a vendor or cloud environment is breached?
Seald Healthcare is designed so that compromising the environment storing the data does not, by itself, provide the authority required to decrypt the protected records. Patient data remains encrypted, and decryption still requires an authorized request that satisfies the active policy.
How does Policy Studio work?
Policy Studio is powered by Marlow, the AI that operates Seald Healthcare. Marlow analyzes your BAAs, vendor contracts, and security requirements and drafts record-level access policies. Your organization reviews and approves each policy. Seald Healthcare then enforces it cryptographically on every decryption request.