Smarter Infrastructure. Stronger Outcomes.

Build a more connected, efficient, and member-focused payer organization.

Software Development Company California

From FHIR-powered data exchange to AI-driven risk management, we deliver scalable technology solutions that help you meet regulatory demands, control costs, and improve care coordination — all without disrupting your existing systems.

  • CMS Compliance Built In
  • Member Experience Elevated
  • Data-Driven, Value-Based Ready

What we do for Healthcare Payers

FHIR Integration Services

Turn interoperability into a strategic advantage. We help payers unlock real-time data exchange across EHRs, claims systems, and partner platforms using modern FHIR frameworks — improving automation, care coordination, and regulatory alignment.

Streamline member data exchange and automate claims processes with FHIR-based infrastructure that reduces manual intervention and accelerates payouts.

Simplify prior authorizations and support proactive care coordination by connecting clinical and administrative data — in real time.

Maintain an accurate, compliant, and easy-to-navigate provider directory that supports transparency and interoperability across your network.

Digital Development

Deliver intuitive, modern digital experiences that engage members and empower your teams. From self-service portals to intelligent analytics platforms, we build custom solutions that reduce friction, increase transparency, and drive better health plan outcomes.

Engage members more effectively with web and mobile platforms built for ease, transparency, and personalized experiences.

Use AI to detect anomalies in claims and identify fraud patterns early — saving time, money, and reputational risk.

Support your shift to value-based care with platforms that track risk scores, care gaps, and outcomes — helping you align incentives while managing costs.

Consulting and Operations

Your roadmap to compliance, efficiency, and growth. Our strategic advisory services help you navigate CMS mandates, optimize core operations like claims and data governance, and modernize aging systems with clarity and control.

Navigate evolving CMS mandates with clarity. We’ll help you define a FHIR roadmap that aligns with your compliance goals and tech maturity.

Improve how your organization handles sensitive healthcare data with security-first data governance frameworks built specifically for payers.

Optimize your claims processing systems to reduce cycle times, minimize errors, and free up your teams to focus on higher-value work.

Data Analysis and AI

Transform your data into real-time insight. We design AI and analytics solutions that uncover risk, streamline documentation, and guide smarter population health decisions — all while keeping compliance and scalability at the core.

Anticipate population health trends with predictive analytics that help drive proactive interventions and resource allocation.

Automate risk adjustment and streamline quality reporting with AI tools that continuously adapt and learn — improving accuracy without adding overhead.

Case Studies

Explore some of Pegasus One’s success stories.

AI-Powered Claims Analytics and Fraud Detection

FHIR-Based Provider Directory for CMS Compliance

Why choose us

When it comes to healthcare payers, we understand the balance you’re managing — reducing cost, meeting regulatory requirements, and improving member outcomes, all at once.

Here’s what makes us uniquely positioned to help:

  • FHIR-Driven, Payer-Specific Solutions
    We design integration strategies and tools specifically for payer workflows — not repurposed from provider use cases. Our solutions are tuned to claims logic, authorization flows, and compliance requirements.

  • Compliance Isn’t an Afterthought
    We’ve delivered solutions that align with CMS, ONC, and NCQA standards — ensuring your digital transformation doesn’t just innovate, but also stays audit-ready.

  • Proven Experience Across the Stack
    From building AI fraud detection systems to developing member portals and care management dashboards, we bring technical depth and real-world implementation success.

  • Data Strategy with Business Impact
    We bridge the gap between your data and your goals — whether that’s risk adjustment, better quality scores, or smarter engagement strategies.

  • Secure, Scalable, Sustainable
    Whether modernizing legacy infrastructure or launching something new in the cloud, our solutions are built to grow with your organization — securely and cost-effectively.

Quick reads

Authored articles from Pegasus One.

  • Challenges and Opportunities for FHIR Implementation in Healthcare

    Challenges and Opportunities for FHIR Implementation in Healthcare

  • The Future of Interoperability: How AI Supercharges FHIR Implementation

    The Future of Interoperability: How AI Supercharges FHIR Implementation

  • Accelerating Digital Health Innovation: Overcoming Challenges and Embracing Opportunities

    Accelerating Digital Health Innovation: Overcoming Challenges and Embracing Opportunities

Ready to transform the way you work?

Your teams are stretched. Your systems are complex. Your members expect more — and so does CMS. We get it. That’s why we deliver solutions that aren’t just compliant, they’re strategic assets for your business.

If you’re ready to move faster, work smarter, and serve members better — let’s talk. No fluff. Just real results, powered by real healthcare tech expertise.

We deliver extra-ordinary outcomes
for extra-ordinary clients

Working with you was an awesome experience! Thank you for improving our site performance fifteen-fold within a few days.... Working with you was an awesome experience! Thank you for improving our site performance fifteen-fold within a few days

Johnson Bruce

Thanks to you, our company now has time to concentrate on the important things, and not worry about who will devlop and grow our product

Kathleen Webber

As a verteran of many systems-development projects, I was particularly impressed with your implementation speed, adaptability to multiple changes, timely improvement recommendations, warnings about potential problems.

Nathan Chaffey

your company has worked on a variety of complex projects for us. We return again and again because your team is very talented and dedicated to delivering high-quality work products at a very competitive price point.

Donnie McWilson
software clients pegasus one

PEGASUS ONE AT
A GLANCE

Inc 5000

5-time Inc 5000 honoree (2019, 2020, 2021, 2023 & 2024)

Rating Star New

Rated 4.9 stars by clients on Clutch

AI Inner Circle

Part of the prestigious Microsoft AI Inner Circle program.

Healthcare Gov Covered California

Part of multiple prestigious civil-society betterment projects

Inc 5000 Microsoft Gold Amazon Parnet Company

Microsoft Solutions Partner and AWS Advanced Consulting Partner

Webby Awards

Apps consistently featured by leading design awards.

TALK TO OUR EXPERTS

Frequently Asked Questions

HL7 FHIR (Fast Healthcare Interoperability Resources) is a standard developed by Health Level Seven International (HL7) to enable seamless electronic exchange of healthcare data. It uses modern web technologies like RESTful APIs to make data accessible, computable, and interoperable.

Unlike older standards such as HL7 v2 or CDA, FHIR is built with modern web technologies, uses granular resources instead of monolithic documents, and is developer-friendly. This makes it faster and easier to implement while offering greater flexibility for various use cases.

FHIR supports robust security protocols like OAuth 2.0 and TLS to protect data in transit. However, healthcare organizations are responsible for implementing additional security measures and complying with regulations like HIPAA or GDPR to ensure data privacy and security.

APIs are the backbone of FHIR, enabling seamless communication between systems. FHIR uses RESTful APIs to retrieve, update, or share specific data in real time, fostering interoperability and simplifying app development.

FHIR organizes healthcare data into modular components called resources (e.g., Patient, Observation, Medication). These resources are standardized, making it easier to exchange data between systems while maintaining a consistent structure.

Yes, FHIR can be integrated with legacy systems through middleware or adapters that map older data formats to FHIR standards. This allows organizations to modernize their interoperability capabilities without completely replacing existing systems.

FHIR’s lightweight, RESTful APIs are perfect for mobile and web applications. Developers can use FHIR to retrieve and display patient data, integrate with wearable devices, and create innovative apps for better patient engagement and care delivery.

Interoperability is the ability of different healthcare systems, applications, or devices to exchange, interpret, and use data effectively. FHIR promotes interoperability by providing a common standard for sharing and accessing healthcare data.

FHIR is increasingly being adopted worldwide by governments, healthcare organizations, and technology vendors. Initiatives like the US CMS Interoperability Rule and Europe’s focus on digital health are driving its implementation globally.

FHIR is continuously updated by HL7 to address emerging needs, such as supporting AI-driven solutions, integrating with IoT devices, and enhancing data exchange for public health emergencies. Its adaptability ensures relevance for future healthcare innovations.

CDA (Clinical Document Architecture) focuses on document-based data sharing, while FHIR offers a modular, resource-based approach. FHIR’s use of APIs and web technologies makes it more flexible and developer-friendly for modern healthcare applications.

Start by evaluating your current systems for interoperability readiness, training your team, and consulting with FHIR experts. Implement pilot projects and gradually expand to fully leverage FHIR’s capabilities.