Plans With Home and
Host Capabilities

We understand the unique needs of community-focused health plans, including the complexities of home and host capabilities and the demands of seamless inter-plan operations. That's why we designed solutions that streamline processes and enhance collaboration across networks while maintaining a strong focus on member satisfaction.

Hear from other health plans offering home and host capabilities:
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How HealthEdge®
Can Help

HealthRules® Edge

HealthRules® Edge, formerly HealthRules® Payer, is our core claims engine: a cloud-native solution that powers accurate, efficient claims administration, delivers industry-leading auto-adjudication rates, and enables stronger financial and operational performance.

Payment Accuracy Edge

Payment Accuracy Edge, formerly HealthEdge Source™, is our prospective payment integrity solution that powers accurate payments for continuous cost containment through end-to-end systems.

Clinical Edge

Clinical Edge, formerly HealthEdge GuidingCare®, is an integrated care management platform that helps improve care quality outcomes and cost management by streamlining care team workflows.

Revenue Align Edge

Revenue Align Edge, formerly HealthEdge Risk Adjustment, enables proactive management and stronger compliance across the payer enterprise by giving health plans a clear, data driven picture of risk.

Provider Atlas Edge

Provider Atlas Edge, formerly HealthEdge Provider Data Management, helps reduce operational friction, compliance risk, and administrative risk through a single, reliable source of truth across the payer data ecosystem.

Payment Accuracy Edge

Payment Accuracy Edge, formerly HealthEdge Source™, is our prospective payment integrity solution that powers accurate payments for continuous cost containment through end-to-end systems.

Clinical Edge

Clinical Edge, formerly HealthEdge GuidingCare®, is an integrated care management platform that helps improve care quality outcomes and cost management by streamlining care team workflows.

Revenue Align Edge

Revenue Align Edge, formerly HealthEdge Risk Adjustment, enables proactive management and stronger compliance across the payer enterprise by giving health plans a clear, data driven picture of risk.

Provider Atlas Edge

Provider Atlas Edge, formerly HealthEdge Provider Data Management, helps reduce operational friction, compliance risk, and administrative risk through a single, reliable source of truth across the payer data ecosystem.

HealthRules® Edge

HealthRules® Edge, formerly HealthRules® Payer, is our core claims engine: a cloud-native solution that powers accurate, efficient claims administration, delivers industry-leading auto-adjudication rates, and enables stronger financial and operational performance.