About Primex Systems
Deep expertise. Senior attention. Real outcomes.
Our success is measured by yours.
Primex Systems is a specialized healthcare technology consulting firm focused on one thing: helping organizations make their healthcare data systems work the way they're supposed to.
We work alongside health plans, providers, clearinghouses, and managed care organizations to help plan, build, and integrate the systems that drive their operations - prior authorization workflows, EDI transaction pipelines, FHIR APIs, and the compliance infrastructure behind them.
Engagements are kept small and focused. You work directly with senior consultants who have lived in these domains - not a project manager who hands work off downstream. We embed with your team, learn your constraints, and help build solutions your people can own and maintain long after we're gone.
- Payers, providers, clearinghouses, and managed care organizations
- Medicare Advantage, Medicaid, and commercial markets
- Clinical intake through to financial settlement
- 837P/I/D claim submissions and 835 remittance processing
- 278 prior authorization request and response automation
- 270/271 eligibility and 276/277 claim status loops
- Prior Authorization API built to CMS-0057-F specification
- Provider Access API and Payer-to-Payer Exchange
- SMART on FHIR / OAuth 2.0 authentication and security
- Gap assessments and phased implementation roadmaps
- 72-hour urgent / 7-day standard PA decision timelines
- Denial transparency and appeals workflow design
Primex Systems was founded on a simple frustration: too many healthcare technology engagements end with a slide deck, a handoff, and a system that still doesn't quite work.
I've spent 15+ years building healthcare technology from the inside out - not consulting from a distance, but designing, architecting, and shipping systems that real teams depend on every day. That work spans prior authorization workflows, EDI transaction pipelines (837/835/834), FHIR R4 APIs, eligibility and claims processing, and the security and compliance infrastructure that holds all of it together.
Over the years I've built a reputation for two things: solving problems that don't have clean answers in any documentation, and building systems that don't need to be rebuilt six months later. Healthcare data problems almost always sit at the intersection of regulatory complexity, legacy constraints, and modern technical standards - navigating that requires someone who understands the clinical and operational reality on the ground just as well as the technical architecture in the room.
I approach every engagement the way a product builder approaches a problem: thinking through how the system needs to work not just today, but under load, under audit, and after I'm gone. That means architectural decisions made for the right reasons - systems that are clean, maintainable, and built on solid foundations from the start. Healthcare systems carry too much operational and compliance risk to get the structure wrong.
More recently, that work has expanded into AI-powered automation - applying intelligent workflow tools to the high-volume, high-stakes processes that still run manually in most healthcare organizations. The opportunity to reduce friction and error rates in prior authorization, eligibility, and claims processing through AI is significant, and it's an area I'm actively building in.
What I've learned across all of this is that most "broken" systems aren't broken because of bad technology. They're broken because the system was never designed around how the team actually works. Fixing that requires someone who can hold both the technical depth and the operational reality in mind at the same time - and build something that bridges them.
When you work with Primex Systems, you're working directly with me - someone who has been doing this work for 15+ years and is putting that experience on the line for your project.