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Health Insurance Software Development Services
Since 2012, ScienceSoft engineers secure digital solutions that help health insurers automate their service operations and leverage advanced technologies for faster and more accurate insurance workflows
Health insurance software development services are meant to help insurance companies and healthcare providers improve the efficiency of their insurance-associated workflows and boost customer experience via digital software solutions.
Having decades of experience in insurance software development and healthcare IT, ScienceSoft understands the unique requirements of the meticulous, highly regulated health insurance industry and knows how to meet them pragmatically and safely. We provide comprehensive services from software design and engineering to testing and compliance to deliver quality software that brings long-term value and enables innovative business models.
Who We Serve
Health insurance carriers
Health insurance agencies
Health insurance brokers
Health reinsurers
Healthcare providers partnering with insurers
Enterprises offering health insurance for their employees
Insurtech startups
Health insurance software product companies
Explore ScienceSoft’s Featured Success Stories
Software to Transform the Entire Health Insurance Cycle
Depending on your needs, we can engineer a multi-functional system to digitally transform the entire medical insurance process or a specialized solution to automate a particular operational area. The examples of health insurance software we create include:
Health information exchange (HIE) software
HIPAA-compliant electronic data interchange (EDI) software that enables automated exchange of protected health information between insurers and healthcare providers.
Software that automates customer risk assessment and offers analytics-based calculation of personalized health insurance premiums.
Software that automates the entire health insurance policy cycle, from issuing through updating to renewal or termination.
Software that provides automated calculation of due payment amounts and deductibles, invoice generation, and processing of the received digital payments.
Eligibility verification software
Healthcare provider software that offers automated verification of policyholder eligibility for particular medical services against the insurance coverage.
Web portals that provide self-service options, secure access to the required data, and instant multi-party communication for insurers' customers, brokers, agents, internal teams, and external partners.
Web and mobile apps that enable prompt insurer-client interaction, convenient application creation, payment, claim filing, and access to health insurance data for customers.
Health insurance marketplaces
Software that helps individuals and businesses find the best-fitting health insurance products among multiple options available with different insurers.
Intelligent virtual assistants
AI-powered chatbots that help companies participating in the health insurance process (agents, insurance carriers, healthcare providers, etc.) automate customer communication and provide 24/7 support.
Software that offers immutable recordkeeping, full traceability, and secure sharing of health insurance data. It can provide complete automation of multi-party workflows using smart contracts.
Software to Support Your Unique Health Insurance Processes
ScienceSoft delivers custom solutions that enable standard and tailor-made health insurance plans and support both conventional and innovative health insurance models.
Health insurance types
- Individual health insurance.
- Family floater health insurance.
- Senior citizen health insurance.
- Children’s health insurance.
- Group health insurance.
Health insurance plans
- Health maintenance organization (HMO).
- Preferred provider organization (PPO).
- Exclusive provider organization (EPO).
- Point-of-service (POS).
- High-deductible health plan (HDHP).
- Gap insurance plans for critical illness insurance, accident insurance, dental and vision insurance, etc.
Health insurance models
- Traditional long- and mid-term health insurance.
- Short-term health insurance.
- Medical microinsurance.
- Pay-as-you-live health insurance.
- P2P health insurance.
Why Build Health Insurance Software with ScienceSoft
- Since 2012 in insurance IT.
- Compliance experts with 5–20 years of experience to guarantee software adherence to the necessary legal standards.
- Since 2003 in cybersecurity to ensure world-class protection of health insurance solutions.
- Since 1999 in web development and since 2005 in mobile to deliver health insurance apps that provide convenient and intuitive user journeys.
- Proficiency in AI/ML, big data, blockchain, IoT, AR to build innovative insurtech solutions.
- In-house project management office to manage large-scale health insurance projects.
- A quality-first approach based on an ISO 9001-certified quality management system.
- Robust security management supported by ISO 27001 certification.
What makes ScienceSoft different
We achieve project success no matter what
ScienceSoft does not pass mere project administration off as project management, which, unfortunately, often happens on the market. We practice real project management, achieving project success for our clients no matter what.
ScienceSoft USA Corporation Is a 3-Year Champion in the Financial Times Rating
Three years in a row (2022–2024), the Financial Times has included ScienceSoft USA Corporation in the list of 500 fastest-growing American companies. This is the result of our dedication to driving project success despite any constraints and disruptions.
Our Practices to Succeed in Health Insurance Software Projects
ScienceSoft’s teams drive each project to its goals by keeping within the agreed cost and timeframe, quickly responding to emerging risks, and maintaining transparent cooperation flows.
Follow the links to discover the software development and project management practices underpinning our approach.
Cost control and optimization
- Flexible pricing models for each project.
- Accurate project scoping to prevent budget leaks.
- Using platform-based development, pre-built app components, and open APIs where applicable to reduce the share of costly custom code.
Agile development
- Quick project start (1–2 weeks).
- An MVP of health insurance software in 3+ months.
- Frequent releases (every 2–4 weeks).
- Well-established Lean, Agile, and DevOps cultures.
- On-demand team upscaling to speed up development.
Cooperation
- Mature practices of collaborative planning, decision-making, and problem-solving.
- A tailored set of KPIs to measure project success.
- Regular reporting on the accomplished tasks.
Risk management
- Realistic resource estimates to ensure project predictability.
- Early identification of potential risks and accurate risk mitigation planning.
- Scrupulous software documentation.
- Structured and controllable change management process.
Establishing software security
- Designing secure architectures for health insurance solutions.
- Implementing advanced security mechanisms: AI-supported UBA, biometric authentication, health insurance data hashing, and more.
- Applying a mature DevSecOps approach.
Ensuring software longevity and interoperability
- Using modern cloud architectures (microservices, serverless) to ensure high scalability and easy evolution of the software.
- Prioritizing updatable tech stack components to extend the software useful life while optimizing revamp costs.
- Building custom APIs to enable seamless software integration with all required systems.
Our BFSI Customers on ScienceSoft’s Approach to Development
ScienceSoft demonstrated a deep understanding of our requirements, and their insurtech developers needed minimal supervision. What stood out was ScienceSoft's proactive suggestions for cost-saving architecture design and tech stack solutions. Their input ensured we stayed within budget without compromising on software quality. The value we derived from partnering with ScienceSoft is definitely worth the investment.
Partnering with ScienceSoft has been an excellent experience. Their team transformed our underwriting platform into a well-oiled machine. They identified and fixed several longstanding issues that had been causing us persistent difficulties. Their communication was exemplary; unlike our previous experiences with outsourcing, we never had to chase them for updates, and they were always prompt in responding to our queries.
We relied on ScienceSoft to bring functionality and form to our scope, filling in the blanks with their development experience in this space. When challenges arose, they problem-solved and elicited maximum potential with every system improvement. Ultimately, they took this project to heights I never expected it to reach.
Technologies and Tools ScienceSoft Relies On
Advanced Techs to Power Your Health Insurance Solution
Click on the cards below to explore the advanced technologies ScienceSoft implements to bring additional value across health insurance workflows.
McKinsey predicts that by 2030, almost all insurance underwriting tasks and more than half of claims settlement workflows will be automated, mainly thanks to AI. Although over 90% of insurers are already using or planning to use AI, most deployments are small-scale, single-purpose tools like chatbots or standalone analytics components. This means that insurers that commit to AI-driven automation at the enterprise scale can still significantly outpace their competitors.
However, to succeed in AI initiatives, you first need secure, standardized data acquisition pipelines and a high-performing data processing environment capable of running AI-supported operations at scale. At ScienceSoft, we start insurance AI projects with an all-around audit of your data management framework, define the missing components critical for the seamless AI system functioning, and help establish a secure and compliant data infrastructure.
Health Insurance Software Development Cost
Based on ScienceSoft’s past insurance software projects, the cost of health insurance software development may range from $120,000 to 3,000,000+, depending on solution scale and complexity, the number of integrations, as well as performance, scalability, security, and compliance requirements.
Want to know how much your health insurance software will cost?
Learn the Cost of Your Health Insurance Solution
Please answer a few simple questions about your needs to help our experts calculate your quote quicker.
Thank you for your request!
We will analyze your case and get back to you within a business day to share a ballpark estimate.
In the meantime, would you like to learn more about ScienceSoft?
- Project success no matter what: learn how we make good on our mission.
- 12 years in insurance IT services: check what we do.
- 4,000 successful projects: explore our portfolio.
- 1,300+ incredible clients: read what they say.
FAQ About Health Insurance Software Engineering
Do we really need custom health insurance software when there are ready-made tools on the market?
Based on what we heard from our clients in the insurance field, these are the six most widespread limitations of OOTB software that caused them to go for custom development:
- The inability to introduce custom automation rules (e.g., for risk scoring, claim approval) and automate highly specific tasks like medical image analysis for loss adjustment and fraud detection.
- The lack of support for innovative insurance models like parametric health insurance and health microinsurance.
- The excessive cost or technical impossibility of integrating OOTB software with legacy business systems.
- The lack of software compliance with region-specific regulations like NYDFS, CCPA, GDPR.
- Limited or costly software scalability.
- The need to purchase individual user subscriptions for large teams, resulting in high software TCO in the long run.
At ScienceSoft, we analyze the feasibility of custom health insurance software development on a case-by-case basis to guarantee the expected economic value for our clients. If off-the-shelf software appears to be a better fit for our client’s case, we are ready to assist with selecting and implementing the optimal solution.
What are your cooperation models for health insurance software projects?
Depending on the client’s needs, ScienceSoft can provide full outsourcing of health insurance software engineering, a dedicated team to take over a part of the development project, or staff augmentation with our best talents. Explore the detailed comparison table composed by our consultants to understand the specifics of each sourcing approach.
How do you ensure regulatory compliance?
We design custom health insurance solutions with HIPAA, GDPR, NYDFS, and other legal requirements in mind, ensure 95%+ test coverage for the coded compliance rules, and run compliance pre-audit before the software launch. If you are entering an emerging market, we go the extra mile to investigate its health insurance regulations and determine the relevant compliance requirements to cover. We can also take over ongoing compliance maintenance. Visit our dedicated page to learn how we ensure BFSI software compliance at each SDLC stage.
Will you sign an NDA?
Sure. We are ready to sign an NDA before an introductory call to legally protect your sensitive data from the onset.
Choose the Service Option that Best Suits Your Needs
Health insurance software consulting
We design the optimal functionality, architecture, UI, and tech stack for your solution and provide expert advice on security and compliance. You also get a detailed project roadmap for smooth implementation.
Health insurance software engineering
We develop your solution end to end, from software design to integration and QA. We can also conduct user training in a convenient format and provide ongoing support. You benefit from superb software quality and prompt implementation.
Health insurance software modernization
We upgrade your legacy software's architecture, codebase, and tech stack and add new automation features. You get a modern solution at an optimal cost and with minimal disruption to your business operations.