Is Your Health Plan Ready for Touchless Claims Processing? The pace of change in healthcare continues to accelerate. Don’t let outdated technology keep your organization from seizing new...
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Health plans with home and host capabilities have set the standard for healthcare excellence since 1929—but mounting industry pressures constantly challenge these market leaders. Decreasing...
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NorthWinds Technology Solutions, a premier technology provider for dentistry organizations, faced significant operational hurdles that yielded low auto-adjudication rates ...
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At HealthEdge®, our team understands that efficient provider data management is fundamental to delivering quality healthcare. Yet, the reality for many health plans is that maintaining accurate...
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Sutter Health Partners with HealthEdge to Centralize Provider Data, Enhance Data Quality, and Build a Scalable Foundation for Future Growth
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Expert Guidance to Solve Operational Challenges, Optimize Performance, and Move Your Business Forward
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Provider data management systems of record are being evolved by healthcare payers that want to automate workflow, solidify data, & enable flexibility in their back office to reduce operational costs.
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Explore how the Global Professional Services team partners with health plans to build custom code solutions across four key service areas.
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HealthEdge® announces the AI Claims Summarizer, a new, intelligent feature integrated into the HealthRules® Payer platform.
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Locating and validating information from siloed sources is like solving a giant crossword puzzle without clues. Separate systems and manual updates lead to pieces not fitting together...
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HealthRules® Payer is leveraging AI to define the next-generation core administrative processing system with unprecedented automation, agility, and insight.
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Core administration modernization and replacement initiatives remain a top priority for healthcare payers. The market size is expected to grow at a rate of 7.8% from 2024-2030, largely attributed...
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Explore our AWS Cloud Migration FAQ. See how HealthEdge empowers health plans with scalable infrastructure, predictive AI, and seamless compliance.
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HealthRules Payer is a next-generation core administrative processing system (CAPS) that delivers differentiation in seven critical areas essential for overcoming complex healthcare challenges.
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As the environment for health plans evolves rapidly, now is the time to modernize CAPS to enhance your ability to compete for members, improve efficiencies, and help maintain compliance.
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Health plans are grappling with the challenge of reducing operating costs without sacrificing clinical outcomes. At the heart of this challenge lies the core administrative processing system...
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HealthEdge HealthRules® Payer delivers next-generation claims administration that transforms how modern health plans operate.
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For many payers, maintaining accurate provider information is complicated. Managing disparate data sources, analyzing information, and reviewing existing records can feel like trying to solve a...
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