When it comes to claims processing, it’s easy to look at an error rate of 3-7% and be satisfied with your progress. But if you dig deeper, you may see a different, more concerning picture. Every...
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The traditional post-pay model has long been the standard in healthcare claims adjudication. However, it can result in significant administrative burdens and increased costs for healthcare payers....
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Provider abrasion is an ongoing challenge for health plans, resulting in damaged trust, increased workloads, and unhappy providers. The problem usually arises from claim denials, payment delays,...
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Managing complex healthcare claims requires a flexible editing system that adapts to the unique needs of your health plan. Traditional claims editing tools often fall short, leaving you vulnerable...
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Transformation throughout the healthcare industry is reshaping the relationship between consumers and their health plans. Consumers are demanding more personalized and dynamic experiences, making...
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A staggering 29% of healthcare consumers said they intend to change health insurance carriers in the coming year, signaling a wake-up call for the industry. HealthEdge conducts an annual...
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The healthcare landscape is fiercely competitive, with both established payers and innovative disruptors vying to capture market share. Yet, in this rush, a crucial factor often gets overlooked:...
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Has your health plan ever processed claims for the month, only to be hit with a new regulation or a provider contract update? This frustrating cycle of retroactive changes is a consistent pain...
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Implementing value-based care has become crucial for many payers looking to enhance patient outcomes while managing costs. HealthEdge Source™ makes it easier for health plans to understand the...
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Healthcare payers are adopting flexible, scalable digital solutions to meet market demands and grow membership. HealthEdge Source™ is designed to help health plans win new business opportunities...
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Healthcare payers are turning to innovative digital solutions to maintain payment integrity. But ever-shifting guidelines can make it challenging to pay claims accurately the first time—costing...
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