Health Plan Operations. Reimagined.
Monument Systems’ AI automation platform is purpose-built for health and PACE plans—combining software, services, and deep healthcare expertise to streamline operations end-to-end.
Who We Are
Monument Systems LLC is a leading innovator in health plan administration solutions and care management software delivering modules that combine intelligence, scalability, and ease of use to Health Plans, Delegated IPAs, Medicare, Medicaid, and Managed Care markets. The company's flagship product, Monument Xpress™ has been providing highly efficient and cost-effective core claims administration in the market since 1999.
What sets us apart is exceptional service, evolution and innovation, rational pricing, speed to implement, and a passion for partnership. With offices in Arizona and in India, Monument Systems also provides Business Process Outsourcing (BPO) services and Business Processing as a Service (BPaaS) to the healthcare industry. Trusted by clients in healthcare who are looking for more than just a vendor, Monument Systems is committed to helping organizations harness technology to achieve lasting success.
“We partnered with Monument to support Medicaid enrollment for our PACE participants via their Xpress Enroll solution. The experience has been consistently and overwhelmingly positive. Their platform is reliable and effective, providing the functionality we need to manage a complex and highly regulated process. What truly sets them apart, however, is their depth of industry experience and their approach to partnership. They understand the nuances of PACE including Medicaid and Medicare eligibility in a way that goes beyond software. More importantly, they approach our challenges as if they were their own, bringing thoughtful solutions, responsiveness, and a genuine commitment to our success.”
Chief Medical Officer
Scale with Leading Support
Monument Systems is building a new AI-driven operations platform for managed care. We have built and operationalized our proprietary AI model for Prior Auth automation to address CMS 0057 Final Rule, and we have added AI to all of our modules such as Xpress™ Communication, Enrollment, Claims, and Appeals and Grievances. Results are impressive i.e., a 92%+ accuracy for triage, 90%+ improvement in turnaround time (TAT) for Prior Auth and a 100% manual to automation and accuracy for faxes at a regional Medicare Advantage health plan.
Implement Quicker
Most claims implementations take years to implement – not at Monument Systems. Depending on the complexity of benefits, the size of the health plan, the number of APIs, or the number of other vendors involved, our implementations can take 30 days e.g., for Xpress™ Communication; two to four months for Xpress™ Auth, our Prior Auth module; or six months for Monument Xpress™, our Claims system. Take a look:
| Capability | Delivery Time |
|---|---|
| Communication API Integration | 1 Month |
| Member Status Portal | 21 Days |
| Fax UI Tracker (Live Feed) | 10 Days |
| Inbound Fax Automation | 7 Days |
| Notification Manager | 10 Days |
Mission-critical deliverables are done in weeks, not months.
Speed is our superpower. We move with your business.
Scaled With Their Growth
By combining advanced healthcare software from Monument Systems, deep industry expertise, and AI-driven intelligence, health plan operations can achieve greater accuracy in claims processing, appeals, and compliance, reducing errors while improving outcomes for members and providers alike.
Improved Accuracy for one of our clients:
“More cases, faster, with fewer hands.”
- Built a digital pre-auth engine that scales with their growth
- Increased 3x in productivity, same headcount
- Achieved 92% AI-driven triage accuracy
- Improved TAT by 90% by implementing AI
- Delivered key digital capabilities in < 3 weeks each
This is not just a tech implementation — it’s a transformation in how business operates.
Our Modules - with or without BPO Services
Monument Xpress™ Claims
Xpress™ is a fully loaded core claims processing system but implemented in half the time, and at half the cost.
Learn MoreXpress™ Auth
AI-driven prior auth automation that accelerates approvals, ensures compliance, and improves provider and member experience.
Learn MoreXpress™ Communication
Secure, intelligent fax and communication automation that eliminates manual handling and integrates with plan workflows.
Learn MoreXpress™ Enroll
AI-driven enrollment for Medicare, Medicaid and Commercial lines of business. Connect direct with CMS.
Learn MoreXpress™ Appeals & Grievances
AI driven for more accurate case resolution while ensuring complex regulatory requirements and deadlines.
Learn MoreXpress™ Clinical Assistant
Standalone AI web + mobile tool for clinical decisions. Human-approved for Prior Auth and Clinical Appeals.
Learn MoreXpress™ Intake
Automate and categorizes intake from multiple channels (portal, fax, email, EDI and API), validates eligibility, classifies and routes it forward.
Learn MoreXpress™ Workflow
Configurable web + UI to build and link tasks into workflows. Models improve with time and usage.
Learn More“Indeed, the new Xpress™ UI (user interface) looks very nice and I would have loved to have this back when the Exclusive Care plan was active at Riverside County. We appreciate Monument’s partnership over the years.”
County of Riverside
Our Partners
