This TCS white paper advocates modernizing healthcare claims systems from monolithic, product-specific setups to modular, API-enabled platforms that support agility, integration, and value-based care. It outlines “CORE & IMMUNE” principles: configurable, open-API, regulatory-compliant, unified user experience, AI-powered operations, modular design, monetization via XaaS, broader user access, and ecosystem enablement. A “claims highway” model with multiple entry/exit points enables flexibility and scalability. Incremental transformation, process simplification, and alignment with business goals help payers shift from claim administrators to health-value orchestrators.

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