HealthRules Payer

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: 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: 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

Data Sheet: HealthRules® Payer Web User Interface

Leveraging our modern, web-based platform, the new web UI enhances usability, and aligns with industry standards for cloud-based healthcare systems.

Infographic: Legacy vs. Next-Generation Core Administrative Processing Systems (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 effciencies, and maintain compliance.

Data Sheet: Optimize Efficiencies with Integrated HealthRules Payer Solutions

HealthRules® Payer is a next-generation core administrative processing system (CAPS) designed to revolutionize the operations of health plans of all sizes and types.

Data Sheet: askHE Chatbot for the HealthEdge® Help Center

Paper: Compliance with Prior Authorization Mandates Is a Strategic Opportunity for Payers

A strategy to comply with the final rule issued by the U.S. Centers for Medicare & Medicaid Services suggests that payers should unify systems around their core claims and care management platforms...