Case Studies

Small Changes Lead to Big Impacts: A HealthEdge Case Study of BPaaS in Action

Case Study: Sutter Health Transforms Provider Data Management with HealthEdge®

Success in Action: Regional Health Plan Transformation

Case Study: From Bottleneck to Breakthrough: How Health Plans are Automating Prior Authorization with HealthEdge®

Learn about HealthEdge's Automated Prior Authorization solution, developed by the Global Professional Service team.

Case Study: How a Regional Health Plan Unified Care Management with HealthEdge

Case Study: Large Regional Health Plan Achieves Scalable Success with HealthEdge Source™ Services

The HealthEdge Source Professional Services team supported a large regional health plan with their claims process and scaled their operations to meet growing demands.

Case Study: How HSCSN Strengthened Care Team Confidence and Streamlined Onboarding with GuidingCare University

Disjointed to Dynamic: How Nascentia Health Modernized Care with HealthEdge GuidingCare®

Case Study: Public Employees Health Program - Provider Data Management Enhances Value of Data and Employees Alike

Scaling Smartly: How HealthEdge Helped Curative Health Plan Power Growth and Achieve Operational Efficiencies

Case Study: VillageCareMAX Transforms Operations and Reporting with GuidingCare​

VillageCareMAX transformed its operations, improved care coordination, & enhanced reporting efficiency by implementing HealthEdge’s GuidingCare, unifying workflows & driving better member outcomes.

Case Study: How One Regional, Provider-Owned Health Plan Streamlined Care Management Reporting for Better Regulatory Compliance

Case Study: Highmark Wholecare, Delaware Health Options, West Virginia Health Options

Case Study: How One Regional Health Plan Created a Member-Centric Digital Ecosystem

Health plan executives are pursuing integrated platform solutions that provide better access to data, leading to better member outcomes.

Case Study: SummaCare's Secret to Payment Integrity Success

Learn about SummaCare's journey to streamlined operations, improved payment accuracy, and enhanced provider transparency.

Case Study:Transforming Payment Accuracy and Operational Efficiency at a Large National Health Plan

Discover how one health plan enhanced efficiency, accuracy, and transparency through with HealthEdge Source.

Case Study: Medica Partners With HealthEdge To Improve Member Lives In The Moments That Matter

To streamline its administrative systems, Medica partners with HealthEdge through the use of HRP and GuidingCare

How HealthEdge HealthRules® Payer Helped Medica Transform Claims Operations through Strategic Automation

Faced with growing administrative and medical cost pressures, Medica needed a solution to streamline its claims processing and improve efficiency across its operations.

Case Study: Modernizing with HealthEdge® to Drive Expansion