Claims inaccuracy has long been a pain point in the healthcare industry. Processing inefficiencies lead to challenges like payment delays, retroactive changes, damaged member and provider...
Read Blog
See how over 450 health plan leaders are preparing for 2025!
Learn MoreHealthcare consumers are increasingly demanding choice and control, and health plans are under growing pressure to adapt. In the 2025 HealthEdge® Healthcare Consumer Study, 60% of individuals with...
Read Blog
Artificial intelligence (AI) is moving beyond the experimental phase, and its applications are certainly no longer reserved for very large enterprises. In healthcare, applying AI to improve...
Read Blog
Error - something went wrong!
Enjoying the content? Sign up to our weekly blog email recap!
Thank you!
Accurate and reliable data is the backbone of efficient healthcare operations, facilitating key operations—from claims processing to enhanced member engagement. Yet, for many health plans,...
Read Blog
HealthEdge® recently released its fifth annual Healthcare Consumer Study, one of the most comprehensive consumer surveys in the health insurance industry. This year, more than 4,500 healthcare...
Read Blog
The growth in our country’s Medicaid population has reached an all-time high in this post-pandemic society. Years of Medicaid expansion under the Affordable Care Act and increasing job losses due...
Read Blog
See what 3,500 consumers say about their healthcare experiences
Read the report!Artificial intelligence (AI) has become the catalyst for transformation across various industries, and healthcare is no exception. For health plans, the integration of AI is no longer just a...
Read Blog
Quality performance expectations have reached a turning point in 2025. This year’s Healthcare Effectiveness Data and Information Set (HEDIS) measures, developed and maintained by the National...
Read Blog
Your health plan is constantly growing and expanding—and your digital ecosystem should be able to keep pace and scale with your organization. Whether your health plan is adding new lines of...
Read Blog
Healthcare is undergoing a transformation, and artificial intelligence (AI) is a major part of this evolution. From improving diagnostic accuracy to transforming care coordination workflows, AI...
Read Blog
Health plan executives face increasing demand to deliver frictionless experiences, from streamlined operations to a modern member experience, to stay competitive in a rapidly evolving market. At...
Read Blog
Health plans face complex and multifactored pricing and payment demands. With a robust and flexible platform like HealthEdge’s Source, plans can increase automation while working to optimize...
Read Blog
The digital transformation of healthcare has fundamentally shifted member expectations. Today’s members expect more than convenience. They want clarity on their care, real-time access to guidance,...
Read Blog
In our December IMPACT customer event, we introduced a few key areas of investment at the platform level, and I have some exciting updates to share with you on customer experience, integrations...
Read Blog
Health plans face evolving industry dynamics that demand quick action and measurable outcomes. Rising member expectations, regulatory requirements and financial considerations all point toward the...
Read Blog
The healthcare industry is entering a critical phase of reinvention. Legacy technologies and decades-old operational models are no longer sufficient in today’s complex, data-rich, and high-demand...
Read Blog
The healthcare payer market is at a critical juncture, driven by increasing market pressures, consumer demands, and the need for technological modernization. At HealthEdge®, we believe payers have...
Read Blog
Healthcare is at a crossroads. Legacy platforms, endless point solutions, and mounting regulatory pressure are all warning signs on the road to change. The need for transformation is clear, even...
Read Blog
Dive into our AI glossary tailored for health plans and payers. Learn essential terms like Machine Learning, Generative AI, and NLP to understand their impact on healthcare operations and payer...
Read Blog
For modern health plans, enhancing auto-adjudication rates is more than a technical upgrade. It is a strategy for payers aiming to stay competitive by increasing automation, improving efficiency,...
Read Blog
Loading More...
HealthEdge Software, Inc. | HealthEdge®, HealthRules®, The HealthRules Language™, GuidingCare®, and the Wellframe logo are registered trademarks of HealthEdge Software, Inc. All Rights Reserved.
