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The HealthRules® Solutions Suite includes the industry’s leading digital claims administration processing system – plus a host of additional value-added capabilities.
Healthrules Solution Suite

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GuidingCare®, our Care Management Workflow solutions, starts with the nation’s most widely adopted care management platform – and provides much more to improve quality of care.
Guidingcare Solution Suite

Prospective Payment Integrity

Source is the preeminent digital prospective payment integrity solution, combining claim payment automation with proactive business intelligence.
Source Solution Suite

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Wellframe Digital Care Management and Digital Customer Service solutions extend the reach of your staff to more fully engage and support members.
Wellframe Solution Suite

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New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

“Operating margin improvement is a top three critical outcome for digital investments in 2024 for 67% of U.S. healthcare payers.”

– Gartner®, Three Operational Excellence Best Practices to Optimize Costs for U.S. Healthcare Payers, 1 November 2023, Mandi Bishop 1

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HealthRules® Payer + HealthEdge Source™

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New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

HealthRules® Payer + HealthEdge Source™

How to Modernize Health Plan Core Administrative Processing Systems

Improve Payment Calculations and Transparency with HealthRules® Payer Machine Readable Files

HRP Executive Release Notes - Q2 2024

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HealthEdge® Machine Readable Files Suite for HealthRules® Payer

HealthEdge® Help Center

HealthRules® Payer Horizons: Improve Member Engagement and Satisfaction

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HealthRules® Payer - IMPACT Spring 2024

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HealthRules Payer

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