Process Before Technology

Every enterprise has an AI strategy.
Not every one works in production. Not every one survives an audit. Not every one scales past the pilot. Not every one knows your industry. Not every one works in production.

Secure Traces delivers AI automation, cybersecurity, custom application development, and Oracle Cloud ERP for regulated industries — with the domain depth that makes the difference between a proof-of-concept and a production system.

Book a Discovery Call → See your industry
Regulated Industry Depth
100+
Practitioners across AI, Security & Cloud
4
Regulated verticals with deep domain fluency
4×
AWS & GCP certified delivery teams
0
Downtime ERP migrations delivered
Industries Served
Pharmacy Benefit Management Healthcare Payers & Providers P&C Insurance FinTech
Trusted Across
Pharmacy Benefit Management
Healthcare
P&C Insurance
FinTech
65% Avg PA cycle reduction
18 wks HITRUST remediation
4 days FNOL cycle vs 11-day avg
What Keeps Your Peers Up at Night

We Named It Before You Had To

Four industries. Four sets of pressures that no generic IT vendor has ever truly understood — until now.

💊
PBM · Prior Authorization
"The CMS-0057-F final rule deadline is live. Our PA system is still manual."
When a formulary exception slips through a manual Prior Authorization queue, the cost isn't just the claim — it's the CMS audit, the member grievance cascade, and the MAC transparency exposure that follows. Real-time PA decision APIs are now a compliance mandate, not a roadmap item.
🏥
Healthcare · Interoperability
"Your EHR vendor sold you interoperability. Your FHIR R4 endpoints disagree."
The CMS Interoperability and Prior Authorization Rule mandates patient access APIs and provider directory APIs on FHIR R4 timelines. Your EHR vendor built the record. Nobody built what surrounds it — the integration layer, the security posture, and the HITRUST audit trail that regulators will ask for first.
🛡️
P&C Insurance · Modernization
"Underwriting speed is a competitive advantage. A 20-year-old policy admin system is not."
Your underwriting model is only as accurate as the telematics data your legacy system can actually ingest. NAIC cybersecurity model law adoption is accelerating across states. And your Cat model data pipeline hasn't been audited for integrity since the last climate disclosure mandate hit.
💳
FinTech · Compliance Engineering
"PCI-DSS v4.0 full enforcement passed in March 2025. Are you compliant?"
Your AML rules engine was written for 2019 transaction patterns. Fraud vectors in 2025 don't respect your lookback windows. The CFPB Section 1033 open banking rule is live. Your investors, auditors, and regulators aren't asking these questions separately anymore — they're asking simultaneously.
Select Your Industry

We Speak Your Language — Before the Contract

Most IT vendors learn your industry after they sign the engagement. We show up already knowing your regulatory calendar, your acronyms, and your architecture.

"Securing adjudication pipelines that process 50M+ claims annually — while the CMS mandate clock runs."

Secure Traces understands the PBM technology stack end-to-end — from real-time and batch NCPDP D.0 adjudication to formulary management engines, step therapy enforcement logic, member eligibility verification, MAC pricing lists, and PBM-to-PBM switching events. We have built AI automation for the Prior Authorization workflow including clinical criteria matching, exception routing, and CMS-mandated real-time PA decision APIs.

Domain Fluency Signals
NCPDP D.0 DAW Codes Step Therapy MAC Pricing CMS-0057-F Prior Auth AI HIPAA Security Rule Rebate Reconciliation
Book a PA Readiness Assessment →
30-minute call · No commitment · PBM-specialist on the call
🤖
Prior Authorization AI Engine
Real-time PA decision APIs, clinical criteria matching, and exception triage automation — compliant with the CMS-0057-F final rule for MA and Part D plans by 2026.
🔴
HIPAA Red Team on Adjudication Systems
Adversarial simulation targeting PBM adjudication pipelines, PII data flow audits, and PHI exfiltration vectors — mapped to HIPAA Security Rule safeguards.
⚙️
NCPDP-Native API Development
Member portals, prescriber-facing PA tools, and formulary management APIs built natively on NCPDP D.0 transaction sets — no translation layer, no latency penalty.
🗄️
Claims & Rebate ERP on Oracle Cloud
Claims processing, rebate management, and financial reconciliation on Oracle Cloud ERP — migrated with zero downtime and audit-ready data lineage from day one.
"Connecting 12 EHR systems without breaking HIPAA, your go-live date, or your HITRUST certification."

Deep experience across payer and provider sides. Payer: claims adjudication, utilization management, HEDIS measure automation, and care gap closure programs. Provider: EHR workflow optimization, clinical documentation improvement, and revenue cycle management. Technology fluency includes HL7 v2.x, FHIR R4, Epic/Cerner API connectivity, and HITRUST CSF v11 certification support.

Domain Fluency Signals
HL7 FHIR R4 HITRUST CSF v11 HEDIS Automation CMS Interoperability Rule HITECH Epic/Cerner APIs PHI Exfiltration Testing Care Gap AI
Book a Health IT Architecture Review →
30-minute call · No commitment · FHIR-specialist on the call
🧠
Clinical RAG & Denials Automation
Retrieval-Augmented Generation for clinical documentation, care gap closure AI, and denials management automation — reducing payer rejection rates at the source.
🟣
HITRUST-Aligned Purple Team
Combined Red and Blue Team exercises mapped to HITRUST CSF v11 control domains — simulating ransomware, PHI exfiltration, and EHR access compromise scenarios.
🔗
FHIR R4 & EHR Integration Dev
Patient access APIs, provider directory APIs, and care ops workflow applications built on HL7 FHIR R4 — compliant with CMS interoperability rule timelines.
💰
Revenue Cycle & Payer ERP
Oracle Cloud ERP implementation for payer revenue cycle management, provider billing, and utilization management — with HIPAA-compliant data migration protocols.
"Modernizing your policy admin system without freezing your underwriting desk for six months."

Carrier and MGA technology experience across commercial and personal lines. Commercial: ACORD data standards, ISO policy form digitization, loss run automation, and reinsurance reporting. Personal: telematics UBI scoring model development. Claims: FNOL intake automation, subrogation detection using ML, and litigation management integration. Plus Cat model data pipeline integrity for climate risk disclosure mandates.

Domain Fluency Signals
ACORD 125/126/127 ISO CGL FNOL Automation Telematics UBI NAIC Cyber Model Law Cat Model Pipelines Subrogation AI LPT Reporting
Book an Insurance Tech Strategy Call →
30-minute call · No commitment · P&C specialist on the call
⚡
FNOL Triage AI & Subrogation Detection
First Notice of Loss intake automation with ML-driven triage, subrogation opportunity detection, and UBI telematics scoring models — cutting average cycle time from 11 days to 4.
🔴
ISO-Aligned Offensive Security
Carrier network pen testing, third-party administrator access risk assessments, and Purple Team exercises aligned with NAIC cybersecurity model law control requirements.
📋
Policy Admin System Modernization
ACORD-native policy system modernization, telematics data pipeline apps, and Cat model data integrity audits — built so your underwriters underwrite, not fight with their systems.
🗄️
Rating Engine & Policy Lifecycle ERP
Oracle Cloud ERP for rating engine automation, policy lifecycle management, and reinsurance reporting — with zero-downtime migration from legacy carrier platforms.
"Building compliance-native payments infrastructure before your Series B auditors ask for it."

Spanning payments infrastructure, digital lending platforms, embedded finance, and wealth management tech. Payments: Visa/Mastercard scheme APIs, ACH/RTP/FedNow integration, ISO 20022 migration. Lending: decisioning engine development, FCRA/ECOA compliance tooling. Open banking: FDX-compliant APIs under CFPB Section 1033. For EU-facing fintechs: DORA operational resilience assessments.

Domain Fluency Signals
PCI-DSS v4.0 FDX Open Banking KYC/KYB Automation AML/BSA Monitoring DORA Resilience SOC 2 Type II ISO 20022 CFPB Section 1033
Book a Compliance Engineering Review →
30-minute call · No commitment · FinTech compliance specialist on the call
🕵️
Fraud Detection AI & AML Monitoring
ML-based fraud detection models, AML transaction monitoring system implementation, and KYC/KYB workflow automation — built for 2025 fraud vector patterns, not 2019 rule sets.
🔒
PCI-DSS v4.0 & SOC 2 Engineering
PCI-DSS v4.0 gap assessment and remediation engineering, SOC 2 Type II readiness, and API security audits — cleared in one audit cycle, not two.
🏦
Open Banking & Payments Platform Dev
FDX-compliant data sharing APIs under CFPB Section 1033, ACH/RTP/FedNow integration, ISO 20022 migration, and lending decisioning engine development with FCRA/ECOA tooling.
📊
Financial Operations & Compliance ERP
Oracle Cloud ERP for financial operations, reconciliation, and compliance reporting — with DORA operational resilience assessments for EU-facing fintech entities.
Four Service Pillars

The Capability Stack That
Regulated Industries Demand

Each service line is built for your compliance environment — not retrofitted to it after the engagement starts.

AI Services
Production-Grade AI.
Not Another POC.
We build Agentic AI and RAG systems that automate high-stakes workflows in regulated environments — Prior Authorization, claims triage, denials management, fraud detection. Our systems go live, stay compliant, and survive your next audit.
  • Agentic AI for PBM Prior Authorization & formulary management
  • Retrieval-Augmented Generation for clinical documentation
  • FNOL triage & subrogation detection models for P&C carriers
  • AML transaction monitoring & fraud AI for FinTech
  • MLOps pipelines on AWS, Azure, and GCP — compliance-aware by design
Schedule an AI Readiness Discussion →
Cybersecurity
Red. Blue. Purple.
Your Attack Surface First.
Offensive and defensive security engagements built for regulated-industry infrastructure — HIPAA adjudication systems, carrier networks, FinTech payment environments. We find what threat actors will find, before they do.
  • Red Team: adversarial simulation on healthcare and PBM systems
  • Blue Team: threat detection, incident response, SIEM/SOAR integration
  • Purple Team: integrated Red + Blue collaborative exercises
  • Defensive: zero-trust architecture, NAIC/HITRUST/PCI-DSS alignment
  • Offensive: API security audits, cloud misconfiguration assessments
Book a Security Posture Review →
Custom App Dev
Security by Design.
From Sprint One.
Full-stack, cloud-native application development for regulated-industry workflows — NCPDP-native APIs, FHIR R4 integrations, ACORD-compliant policy systems. OWASP Dependency-Track runs in every pipeline. Security is not the last step.
  • NCPDP D.0 and FHIR R4 native API development
  • EHR integration (Epic, Cerner) and care ops workflow apps
  • ACORD-compliant policy admin and telematics data pipelines
  • FDX open banking APIs and lending decisioning platforms
  • DevSecOps pipelines with OWASP Dependency-Track and SAST/DAST gates
Start an Architecture Conversation →
Oracle Cloud ERP
Zero Downtime.
Audit-Ready from Day One.
Oracle Cloud ERP and Fusion implementation for regulated industries — migrating from legacy platforms (SAP, PeopleSoft, JD Edwards) with zero-downtime methodology and full regulatory data compliance during migration. Post-go-live support included.
  • Oracle Cloud ERP & Oracle Fusion implementation
  • Zero-downtime migration from SAP, PeopleSoft, and JD Edwards
  • PBM claims & rebate management ERP
  • Payer revenue cycle and provider billing ERP
  • FinTech financial operations, reconciliation, and compliance reporting
Book an ERP Readiness Assessment →
Why Secure Traces

We Don't Sell AI.
We Engineer Digital Solutions.

01
Domain first. Technology second.
We start every engagement by mapping your regulatory environment, your process constraints, and your data model — before we recommend a single technology. Most vendors do it in reverse. That's why 70% of enterprise AI projects fail before production.
02
Specialists, not generalists.
Our 100+ practitioners are aligned to verticals. Your engagement is led by practitioners who have worked PBM adjudication systems, EHR integrations, carrier policy platforms, or FinTech compliance pipelines — not cloud generalists with a regulatory checkbox.
03
Compliance is architecture, not an afterthought.
HIPAA, HITRUST, PCI-DSS v4.0, NAIC model law, CMS interoperability — these are design inputs, not post-delivery checklists. OWASP Dependency-Track runs in every development pipeline from sprint one. Security is not the last step.
04
Cloud-certified, regulated-industry tested.
2× AWS certified and 2× GCP certified delivery teams — with delivery track records in the exact regulated environments where certification alone is not enough. Because passing an exam and delivering a FHIR-compliant production system are very different things.
We Speak Your Language
"We don't learn your industry after we sign the contract. We show up already knowing it."
Pharmacy Benefit Management
NCPDP D.0DAW enforcementStep Therapy logicMAC transparencyCMS-0057-F
Healthcare
HL7 FHIR R4HITRUST CSF v11HEDIS automationCMS interoperability APIsEpic/Cerner
P&C Insurance
ACORD 125/126/127ISO CGLFNOL automationTelematics UBICat model data
FinTech
PCI-DSS v4.0FDX open bankingKYC/KYBAML/BSADORA resilience
Results That Are Specific

Not Testimonials. Outcomes.

We don't use generic quotes. We use numbers — because that's what you'll take to your board.

● PBM
65%
Reduction in manual Prior Authorization review time for a 40M-member PBM. Real-time PA decision API deployed and CMS-0057-F compliant ahead of the mandate deadline.
Agentic AI · Prior Auth Engine · NCPDP D.0 Integration
● Healthcare
18 wks
HITRUST CSF gap remediation completed for a regional payer with 12 EHR system integrations — delivered within the CMS interoperability rule compliance window.
HITRUST CSF v11 · Purple Team · FHIR R4 APIs
● P&C Insurance
4 days
Average FNOL cycle time for a top-20 P&C carrier — down from an 11-day baseline. ML-driven subrogation detection running concurrently, identifying 3× more recovery opportunities.
FNOL AI · Subrogation ML · ACORD Integration
Objections Handled

The Questions Your Peers
Are Already Asking

PBM
Can you integrate with our existing adjudication engine without a rip-and-replace?
Yes — we have built against NCPDP D.0 transaction sets and major PBM adjudication platforms. We extend what you have, not replace it. Our AI layer sits alongside your existing engine and is production-ready in weeks, not quarters.
Healthcare
We already have an EHR vendor. Why do we need Secure Traces?
Your EHR vendor built the record. We build what surrounds it — the FHIR APIs, the AI documentation layer, the HITRUST-aligned security posture, and the workflow automation their roadmap will never prioritize because it doesn't scale across their full customer base.
P&C Insurance
Our legacy policy admin system is 20 years old. Is modernization even feasible?
We have migrated carriers off systems from that era. The constraint is never the technology — it's the data model, the business logic embedded in decades of customization, and the change management. We map all three before we write a line of code.
FinTech
We're pre-Series B. Are we too early for this kind of engagement?
The best time to build compliance-native infrastructure is before your investors, auditors, and regulators ask for it simultaneously — at Series B. We have right-sized engagements for growth-stage fintechs that won't break your runway or your sprint cadence.
General
We already have an internal IT team. Why Secure Traces?
We don't replace your team. We give them the specialized capability — offensive security red teaming, Agentic AI architecture, Oracle Fusion expertise, FHIR integration depth — that takes 18 months and a $2M hiring budget to build in-house. We bring it on day one.
General
We're not sure we're ready for an AI or ERP transformation yet.
Most of our best engagements start with exactly that statement. The 30-minute discovery call is a current-state-to-action-plan conversation — not a sales pitch. We map where you are to where the regulatory and competitive landscape is heading. That clarity is free. The risk of not having it isn't.
The Next Step Is One Conversation

Your Regulatory Calendar
Is Already Running.

The CMS PA mandate. PCI-DSS v4.0 enforcement. NAIC model law adoption. CFPB Section 1033. These aren't future risks — they're present deadlines. The right time to start this conversation was last quarter. The second-best time is now.

Book a Discovery Call — 30 Minutes →
Or request our capability brief · Visit securetraces.com
We're not sure we're ready for this yet.
That's exactly why the first conversation is free and commitment-free. We'll map your current state to a 90-day action plan — covering your compliance gaps, your AI readiness, and your highest-ROI starting point. No deck. No proposal. Just a domain-specialist who already knows your industry.