rajan gupta
the 3am nerd · it × ai × life
no guru. all skill.
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the $2m enrollment failure that changed how i think about integration
upcoming blog post
this one’s brewing — the story of how a single 834 enrollment file brought down a health plan’s member database, and what it taught me about building resilient systems.
what you’ll learn:
- why batch EDI processing without idempotency is a ticking time bomb
- the 3 AM phone call that kicked off a 72-hour war room
- how a missing segment terminator cascaded into $2M in duplicate enrollments
- the architectural patterns we built after to make sure it never happened again
stay tuned. this drops soon.
read more → -
cms prior authorization mandate 2027 — what your integration team needs to know now
upcoming blog post
the CMS Prior Authorization Rule (CMS-0057-F) is coming January 2027. most health plans aren’t ready.
what this post will cover:
- the FHIR R4 APIs you’ll need to build (and the ones that trip everyone up)
- real timelines for PARDD compliance — not the vendor marketing version
- why your current prior auth workflow is about to become a compliance liability
- a practical architecture blueprint for making the switch
coming soon.
read more →