HealthRules Payer

Accelerating Innovation, Accuracy, and Integration Across the HealthRules® Payer Platform

Data Sheet: Business & Technical Advisory Services for HealthRules® Payer

Expert Guidance to Solve Operational Challenges, Optimize Performance, and Move Your Business Forward

Executive Summary: IDC MarketScape — Healthcare's Pressing Need for Provider Data Management Software

Provider data management systems of record are being evolved by healthcare payers that want to automate workflow, solidify data, & enable flexibility in their back office to reduce operational costs.

Executive Summary: Payer Financial Modernization Is Real; Integrate and Interoperate Now for the Seamless Payer/Provider Future

How feasible are seamless core administration and interoperable data at the point of care, given the current provider workflows, interoperability challenges, and siloed incentives?

Data Sheet: Custom Code Services for HealthRules® Payer

Explore how the Global Professional Services team partners with health plans to build custom code solutions across four key service areas.

Data Sheet: AI Claims Summarizer for HealthEdge HealthRules® Payer Optimize Claims Processing with AI-Powered Insights

HealthEdge® announces the AI Claims Summarizer, a new, intelligent feature integrated into the HealthRules® Payer platform.

Data Sheet: HealthEdge HealthRules® Payer AI

HealthRules® Payer is leveraging AI to define the next-generation core administrative processing system with unprecedented automation, agility, and insight.

eBook: Modernizing Health Plan Operations for Agility, Efficiency, and Innovation

Core administration modernization and replacement initiatives remain a top priority for healthcare payers. The market size is expected to grow at a rate of 7.8% from 2024-2030, largely attributed...

Data Sheet: The HealthRules Payer Advantage — What Sets Us Apart

HealthRules Payer is a next-generation core administrative processing system (CAPS) that delivers differentiation in seven critical areas essential for overcoming complex healthcare challenges.

Brochure: Legacy vs Next Gen CAPS

As the environment for health plans evolves rapidly, now is the time to modernize CAPS to enhance your ability to compete for members, improve efficiencies, and help maintain compliance.

Brochure: HealthEdge HealthRules® Payer - Next Generation Claims Administration

HealthEdge HealthRules® Payer delivers next-generation claims administration that transforms how modern health plans operate.

Infographic: Optimize Your Workflow and Maximize Savings with Integrated Secondary Editing for HealthRules® Payer

Enhance claims accuracy and reduce overpayments with HealthEdge Source'' advanced secondary editing integrated directly into the HealthRules Payer platform.

Data Sheet: Enhancing Healthcare Payer Efficiency with HealthEdge Source™ Advanced Custom Edits and Analytics Integration

This use case demonstrates the significant benefits of integrating the Advanced Custom Edits module with Analytics for healthcare payers.

Data Sheet: Optimization Assessment for HealthRules® Payer Customers