Connect to
a truly member-centric experience.
more automated operations.
the next generation of service.
a comprehensive digital transformation.
HealthEdge® solutions – deployed as standalone next-generation SaaS or together as an integrated platform – help payers accelerate their digital transformation and position them for continuous success.
HealthEdge Annual Payer Market Planning Report 2025
HealthEdge surveyed over 450 health plan leaders to explore their challenges, key priorities, and investment strategies for the upcoming year
GET THE INSIGHTSCompliance with Prior Authorization Mandates Is a Strategic Opportunity for Payers
Embrace modern, integrated technology to ensure compliance and create a foundation for long-term operational success.
Read the paperThe Digital Payer Journey to Achieve a Coherent Individual Healthcare Experience
The individual healthcare experience has three dimensions. Each dimension requires deep application focus and an integrated approach to applications and data.
READ MOREHealthRules® Payer named “Best in KLAS®”
HealthRules Payer has been named "Best in KLAS" by KLAS Research for Claims & Administration Platforms for the second year in a row.
READ MOREHealthEdge by the
Numbers
What can HealthEdge
do for you?
Our healthcare SaaS software provides payers with a digital foundation that enables them to deliver a transparent and consumer-centric experience at lower cost while offering higher quality and higher service levels to their members, providers and partners.
see our solutionsA Truly Connected
Ecosystem
Whether connecting to our best-of-breed applications or other third-party systems, HealthEdge enables health plans to access data within and between systems for new digital member experiences. HealthEdge is on a digital journey with our customers to make it easy to exchange real-time data and streamline workflows across once-siloed functional areas and data.
See Our SolutionsHealthEdge
HealthRules Payer
CoreAdministration
Source
ProspectivePayment Integrity
Wellframe
MemberExperience
GuidingCare
CareManagement
Enabling the digital
payer
What does it mean to be a digital payer in today's highly complex and dynamic health insurance market? It means every aspect of your business is constantly improving. While working with hundreds of payers, we consistently see the following five attributes in our digital-first customers:
Become a Digital PayerEver-evolving focus on the member and end-user experience
Modern technology and seamless exchange of real-time data facilitate a better experience
Ever-declining transaction costs
Automating business processes based on accurate data drives down costs and drives up productivity
Ever-improving quality
Accessing accurate insights from real-time data across lines of business and care provider networks results in better health outcomes
Ever-increasing service levels
Empowering team members with modern technology and up-to-the-minute data results in better service
Ever-improving business transparency
Greater visibility and robust analytical tools lead to more informed business decisions