Data Sheet: Member Travel Card & HealthRules Payer
Travel Card members enjoy peace of mind, knowing their healthcare is covered whether they are visiting their primary care doctor in their home neighborhood, traveling across the U.S. for business...
Improving the Care Experience with the HealthRules Payer Member Travel Card Solution
The HealthRules® Payer Member Travel Card Solution enhances healthcare for members, providers, and health plans, particularly those with home and host capabilities. Harnessing advanced data processing technology and automation, the solution significantly reduces costs and improves care accuracy, efficiency, and configurability.
Key Benefits of the Member Travel Card Solution:
Peace of Mind for Members:
- Coverage whether at home, traveling across the U.S., or internationally.
Accuracy:
- Achieves up to 99% financial accuracy, surpassing the industry average of 80%.
- Auto-adjudication rates up to 90%, minimizing manual claims processing.
Efficiency:
- Processes claims without the pre-work of loading host providers.
- Utilizes real-time messaging for efficient pricing.
Configurability:
- Simplified yet comprehensive configuration with industry-based reusable design.
- Flexibility in managing services, benefits, and contracts.
- Override feature for manual adjudication.
- Concurrent management of varied payment arrangements and multiple lines of business.
Why HealthEdge and HealthRules Payer?
HealthEdge, a trusted technology partner for 25 plans with home and host capabilities, offers the HealthRules Payer—rated Best in KLAS in 2022 and 2023 for Payer Claims and Administration Platforms. HealthRules Payer enables plans to move away from outdated infrastructure and manual processes, ensuring accurate, efficient, and configurable claims payments.
Client Testimonials:
A client’s Chief Medical Officer noted, “The HealthRules Payer platform has really enabled us to turn things around [in response to COVID-19 regulations].”
By leveraging the right core administrative processing systems (CAPS) like HealthRules Payer, payers can ensure accurate, efficient, and configurable claims payments, reducing costs and improving member experiences. Providers benefit from timely and accurate billing, fostering loyalty and seamless care for members, wherever they are.
HealthEdge® is a leader in providing modern, disruptive healthcare IT solutions that drive digital transformation in healthcare. Learn more at HealthEdge.
