Payment integrity has always played a critical role in payer operations, but in 2026, it has become a strategic imperative. According to the HealthEdge® 2026 Annual Payer Survey, health plan...
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HealthEdge Source™ earned the 2026 Best in KLAS Awards: Software and Services as the leader in “Pre-Payment Accuracy & Integrity Solutions (Payer)”—with an overall score 8% higher than its...
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Source has been named “Best in KLAS” for Pre-Payment Accuracy & Integrity Solutions (Payer), achieving an overall score of 88.2, a full 6 points above the segment average (81.2).
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Managing payments for a health plan is not as simple as it was a few decades ago. Updated billing models, new compliance mandates, and complex provider networks can make it challenging for payers...
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The HealthEdge Source Professional Services team supported a large regional health plan with their claims process and scaled their operations to meet growing demands.
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A story of how a fictional health plan moved beyond recovery to adopt a proactive, data-driven approach to payment integrity.
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Transform your health plan with AI-powered solutions delivering payment accuracy and operational efficiency. Our platform accelerates clinical reviews, helps reduce costs, and streamlines workflows wi
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A prospective payment integrity solution that manages accurate and compliant pricing data, so health plans don’t have to.
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A prospective payment integrity solution that manages accurate and compliant pricing data, so health plans don’t have to.
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A prospective payment integrity solution that manages accurate and compliant pricing data, so health plans can focus on optimizing member outcomes instead of claims editing and re-work.
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A prospective payment integrity solution that manages accurate and compliant pricing data, so health plans don’t have to.
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Learn about SummaCare's journey to streamlined operations, improved payment accuracy, and enhanced provider transparency.
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Discover how one health plan enhanced efficiency, accuracy, and transparency through with HealthEdge Source.
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HealthEdge Source Advanced Custom Editing lets you build and manage custom claim edits, apply edit history, and control user access. Easily configure complex edit rules and apply them to your claims.
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HealthEdge Source™ is a cloud-based platform for healthcare claims management. It combines claims pricing, editing, and analytics in one system for Medicare, Medicaid, and Commercial claims. All prici
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HealthEdge Source™ Analytics simplifies healthcare claims management by providing tools to analyze claims pricing, editing, and performance. The Financial Impacts Dashboard shows the financial impact
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HealthEdge Source™ (Source) is a cloud-based solution designed to revolutionize payment accuracy and integrity in the healthcare industry.
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A prospective payment integrity solution that manages accurate and compliant pricing data, so health plans don’t have to.
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