Case Study: How a Regional Health Plan Unified Care Management with HealthEdge
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GuidingCare
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See what 3,500 consumers say about their healthcare experiences
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Regulatory & Compliance Q&A: How the OBBBA Could Impact Care Management & Member Engagement
On June 10, 2025, the One Big Beautiful Bill Act (OBBBA), also known as H.R.1, was signed into law, marking the beginning of one of the most sweeping healthcare reforms in recent memory. Given the...
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Future-Proof Your Health Plan with HealthEdge GuidingCare® : FHIR-Driven Solutions Enable Compliance
HealthEdge’s GuidingCare® platform is at the forefront of enabling healthcare interoperability. By combining deep technical expertise with a visionary approach, GuidingCare equips health...
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Streamlining Care, Strengthening Outcomes: The New HealthEdge GuidingCare® FHIR Integration with FindHelp
HealthEdge® continues to deliver leading technology solutions that empower care teams, reduce administrative burden, and support whole-person care. Solving Healthcare’s Hidden Data Disconnect It...
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Scaling AI Thoughtfully: Behind the Scenes of the HealthEdge® GuidingCare Notes Summarizer
By Alice Zhan, AI team Part 2: Technical Implementation This is part two of a two-part blog series on HealthEdge’s AI Summarizer feature; this post focuses specifically on the feature’s technical...
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Leveraging AI to Summarize GuidingCare Notes and Empower Care Managers
In today’s healthcare environment, care managers are at the heart of improving outcomes for members with complex needs. Yet, the growing volume of documentation, assessments, and free-text notes...
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Are you ready to transform compliance into a strategic advantage?
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Data Sheet: Five Steps to Achieving Regulatory Agility in Population Health Management
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AI-Enabled Optical Character Recognition: Transform Manual Processes into Automated Workflows
Fax-based communication and the manual work required to process physical documents remain daily challenges for health plan care teams. Communications related to authorizations, appeals,...
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Data Sheet: GuidingCare Menu of Services
Health plans rely on GuidingCare® to deliver integrated, member-centered care. But maximizing the value of the platform requires more than implementation...
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Data Sheet: Automate Manual Workflows and Accelerate Care Decisions with AI-Enabled HealthEdge® GuidingCare OCR
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Automate & Accelerate Health Plan Rules Deployment with HealthEdge GuidingCare®
The healthcare industry is in constant motion. Regulations change and care models evolve, while competitive pressures and member expectations grow more complex every year. For health plans, this...
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Building Member Trust Using Responsible AI: How to Get It Right
Artificial intelligence (AI) is quickly becoming foundational to the future of healthcare. From automating claims reviews to powering proactive care management, AI has the potential to help health...
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A Care Management Guide for Health Plans: Navigating the One Big Beautiful Bill
The One Big Beautiful Bill Act (OBBBA) is reshaping healthcare, especially for Medicaid and Medicare plans. With tighter budgets, closer oversight, and an emphasis on population health in rural...
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Modernizing Prior Authorization: A Critical Step Toward Delivering Higher-Quality Care
Healthcare payers are under increasing pressure to integrate and unify digital solutions so they can streamline workflows and improve operational efficiency. With the passing of the...
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Data Sheet: GuidingCare® Business Rules Designer
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‘All In on AI’: A Conversation with the HealthEdge® Vice President of Product Management
As artificial intelligence (AI) rapidly transforms healthcare, many leaders are asking what it really means to go all in. For HealthEdge®, it means embedding practical, responsible, and...
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How a Regional Health Plan Unified Care Management with HealthEdge
A HealthEdge customer story that shares how the Professional Services team helped a customer unify their care management operations on a single GuidingCare platform - improving efficiency, streamlinin
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Less Admin, More Care: How the Care Management Note Summarizer from HealthEdge GuidingCare® Helps Care Managers Reclaim Time
Care managers enter the healthcare field to support patients—not drown in paperwork. Yet for many, that’s the daily reality: hours spent sorting through handwritten notes, summarizing past...
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Webinar: From Payers of Claims to Partners in Care - Insights from the 2025 Healthcare Consumer Survey
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HealthEdge Recognized as a Sample Vendor in 2025 Gartner® Hype Cycle™ for Provider Data Management and AI-Enabled Fraud Detection
HealthEdge®, a leading provider of next-generation core administrative processing systems, payment integrity, and care management solutions, has been recognized as a Sample Vendor in two categories of
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