Data Sheet: GuidingCare Menu of Services
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GuidingCare
Explore additional content on the GuidingCare Solution Suite
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See what 3,500 consumers say about their healthcare experiences
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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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Are you ready to transform compliance into a strategic advantage?
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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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Case Study: How a Regional Health Plan Unified Care Management with HealthEdge
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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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ICHRA: The Consumer-Driven Shift Health Plans Can’t Ignore
Healthcare consumers are increasingly demanding choice and control, and health plans are under growing pressure to adapt. In the 2025 HealthEdge® Healthcare Consumer Study, 60% of individuals with...
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Video: How Nascentia Health Modernized Care with HealthEdge GuidingCare®
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Disjointed to Dynamic: How Nascentia Health Modernized Care with HealthEdge GuidingCare®
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How One Regional, Provider-Owned Health Plan Streamlined Care Management Reporting for Better Regulatory Compliance
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HealthEdge GuidingCare® for CalAIM: Your Partner on the Population Health Journey
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Advancing Health Equity: A Leadership Roundtable with HealthEdge
Discover practical insights and innovative strategies shared during our exclusive roundtable, where health plan leaders collaborated on advancing health equity through technology and partnership. This
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Report: Digital Care Management can help lower blood pressure by more than 9%
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