Payer-Source Integration
Integration Overview
Payer-Source is a direct API-based integration between HealthRules Payer® and HealthEdge Source™, designed to streamline administrative processes and maintain payment integrity. This connection allows seamless sharing of data to ensure accurate claims pricing and editing.
By automating workflows, Payer-Source reduces manual effort, improves payment accuracy, and streamlines claims processing. With these systems working together as one, your health plan can achieve greater transparency, make better decisions, and enhance efficiency across payment ecosystem.
Integrated Secondary Editing Solution Now Available to HealthRules® Payer Clients
LEARN MOREA Modern Combination: Claims Administration & Payment Integrity
LEARN MOREKLAS Research named HealthRules® Payer its 2023 “Best in KLAS” payer claims and administration platform
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HealthEdge® recognized as Sample Vendor in 3 categories in the Gartner® Hype Cycle™ for US Healthcare Payers in 2023
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Key Benefits
Single Source of Truth
Payer-Source consolidates all payer data in one place, offering quick access to accurate, up-to-date information to eliminate discrepancies and ensure transparency in payer operations.
Enhanced Accuracy
The solution uses machine learning and advanced data analysis to efficiently review, validate, and cross-check large datasets from multiple sources in real time, ensuring greater accuracy in claims processing.
Increased Operational Efficiency
Through continuous management, the integration reduces manual workflows, minimizes human errors, and ensures proactive compliance with updated edits and pricing data.
Comprehensive Payment Ecosystem
Comprehensive, holistic view of a health plan’s payment integrity ecosystem with the ability to edit at multiple points in the adjudication workflow.
Streamlined Support Model
Native integration reduces the strain on internal IT resources and minimizes risks through a unified setup, with support and guidance provided by the HealthEdge team.
HealthEdge Solutions
Core Administrative Processing System (CAPS)
The HealthRules® Solutions Suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a unique to industry configuration and promotion application, and home and host processing support available on both public and private clouds.
Learn MoreProspective Payment Integrity
Source is a preeminent digital prospective payment integrity solution that natively brings together claim payment automation with proactive business intelligence, enabling payers with Medicare, Medicaid and commercial lines of business to have better relationships with providers, reduce waste and improve their financial performance.
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