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.
Gartner® Hype Cycle™
HealthEdge Named a Sample Vendor for Next-Gen Core Administrative Processing and Prospective Payment Integrity Solutions in the Gartner® Hype Cycle™ for U.S. Healthcare Payers, 2022READ MORE
Voice of the Market: 2022 Digital Transformation Survey
HealthEdge Survey Highlights Growth Opportunities and Challenges for Health Plan LeadersREAD MORE
Prospective Payment Integrity: Moving from "Pay and Chase" to Predictive
This Spotlight examines payer payment integrity platforms and how payers can aggressively apply analytics and coordinate workflows to move "left" from reactive postpay to proactive, predictive prepay.READ MORE
HealthEdge by the
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 solutions
A Truly Connected
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 Solutions
Enabling the digital
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 Payer
Ever-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
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