Data Sheet: Business & Technical Advisory Services for HealthRules® Payer
Expert Guidance to Solve Operational Challenges, Optimize Performance, and Move Your Business Forward
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HealthRules Payer
Discover more about the HealthRules Solution Suite
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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.
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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?
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Top Challenges and Priorities in 2026 for Health Plans with Government LOB
The healthcare payer landscape is undergoing a seismic transformation, as revealed by the 2026 HealthEdge® Annual Payer Report. HealthEdge surveyed more than 550 health plan executives, including...
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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.
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Payer Priorities 2026: Balancing Cost, Compliance, and Connection in a Time of Disruption
The HealthEdge® 2026 Annual Payer Report, “The Great Rebalancing: Inside the New Realities Shaping Health Plan Performance,” reveals how health plans are navigating growing financial pressure,...
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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.
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Data Sheet:The HealthRules Payer Advantage: What Sets Us Apart
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7 Ways a Modern Core Administrative Processing System Can Improve Margins & Efficiency
Health plans are grappling with the challenge of reducing operating costs without sacrificing clinical outcomes. At the heart of this challenge lies the core administrative processing system...
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Brochure: HealthEdge HealthRules® Payer - Next Generation Claims Administration
HealthEdge HealthRules® Payer delivers next-generation claims administration that transforms how modern health plans operate.
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Infographic: Optimize Your Workflow and Maximize Savings with Integrated Secondary Editing for HealthRules® Payer
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Enhancing Healthcare Payer Efficiency with HealthEdge Source™ Advanced Custom Edits and Analytics Integration
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HealthRules® Payer Behind the Scenes: How HealthEdge® Customer Operations Empowers Payers
Discover how the HealthEdge® Customer Operations team makes it easier for HealthRules® Payer customers to meet their business goals. Health plans across the U.S. depend on the HealthEdge...
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How an Integrated Digital Ecosystem Enables Success for Health Plans
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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Video: Next Generation Core Administration Processing
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New Sales Leadership Joins HealthEdge to Accelerate Growth and Support the Expansion of Digital Health Platform
(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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HealthEdge Surpasses Decade Mark as a Sample Vendor for Next-Generation Core Administrative Systems in the Gartner® Hype Cycle™ for U.S. Hea
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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Ten Consecutive Years HealthEdge Listed as a Sample Vendor for Next-Generation Core Administrative Systems in the Gartner Hype Cycle for U.
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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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.
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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.
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