Discover more about the HealthRules Solution Suite
Health plan executives face increasing demand to deliver frictionless experiences, from streamlined operations to a modern member experience, to stay competitive in a rapidly evolving market. At...
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(Burlington, Mass., June 1, 2022) – HealthEdge announced two strategic additions to its sales leadership: Matt Francis, Senior Vice President, HealthRules Payor Sales, and Jeff Jacobs, Senior Vice...
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Burlington, Mass., Aug. 16, 2021 – HealthEdge Software said today it has been named a Sample Vendor for the Next-Generation Core Administrative Systems category in the Gartner “Hype Cycle for U.S....
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Burlington, MA, December 5, 2020 – HealthEdge Software, Inc.® (“HealthEdge”), provider of the industry’s leading integrated financial, administrative and clinical platform for health insurers,...
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Faced with growing administrative and medical cost pressures, Medica needed a solution to streamline its claims processing and improve efficiency across its operations.
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Health plan executives are pursuing integrated platform solutions that provide better access to data, leading to better member outcomes.
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To streamline its administrative systems, Medica partners with HealthEdge through the use of HRP and GuidingCare
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For modern health plans, enhancing auto-adjudication rates is more than a technical upgrade. It is a strategy for payers aiming to stay competitive by increasing automation, improving efficiency,...
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Healthcare payers experience consistent pressure to update and modernize their technology systems to meet evolving industry demands. From regulatory compliance to meeting member expectations and...
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The healthcare industry is evolving at a rapid pace. Regulatory demands, shifting consumer expectations, and the need for data-driven decision-making are placing unprecedented pressure on health...
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The complex landscape of state and federal healthcare regulations continues to evolve, requiring payers to invest in technologies that support their compliance efforts. Next-generation Core...
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Leveraging our modern, web-based platform, the new web UI enhances usability, and aligns with industry standards for cloud-based healthcare systems.
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Health plans today are under increasing pressure to modernize their technology and processes to adapt to the complexities of modern healthcare and take advantage of market growth opportunities....
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Many health plans continue to rely on legacy Core Administrative Processing Systems (CAPS) as the backbone for managing critical operations such as claims processing, benefit configuration, and...
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As the environment for health plans evolves rapidly, now is the time to modernize CAPS to enhance your ability to compete for members, improve effciencies, and maintain compliance.
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In the rapidly evolving landscape of healthcare technology, staying ahead of competitors requires organizational commitment to modernization. Investing in a modern healthcare core administrative...
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HealthRules® Payer is a next-generation core administrative processing system (CAPS) designed to revolutionize the operations of health plans of all sizes and types.
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The ever-changing healthcare landscape requires health plans to have access to the insights and agility necessary to control costs, embrace change, and move quickly to take advantage of new...
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