As Health Plans Prioritize Core Administrative Processing Platforms, HealthEdge’s Solution Again Leads the Category 

HealthRules® Payer from HealthEdge has been recognized for the third straight year as the “Best in KLAS” Claims & Administration Platform by KLAS Research in its 2024 healthcare software and services report. The report recognizes the software platforms ranked #1 in software categories based on the feedback of healthcare professionals and clinicians through 25,000 interviews across more than 4,500 organizations.  

“’Best in KLAS’ is validation that HealthRules Payer is delivering business value and an exceptional experience to leading health plans,” said Anshul Pande, EVP and General Manager HealthRules Payer. “We partner with our customers on their digital transformation journeys, and their input guides how we innovate with our cloud-based solutions, including investment in AI and enhanced automation. Ultimately, our products enable our customers to rapidly adapt in an increasingly regulated and dynamic market.” 

HealthRules Payer is a next-generation core administrative processing system (CAPS) that enables transformational outcomes and business agility for all types and sizes of health plans. Built for an ever-evolving landscape of consumer demands, regulatory change, and competitive opportunities, HealthRules Payer is a modern cloud-based platform with unprecedented levels of flexibility, automation, accuracy, and ease of use. Its market-leading capabilities are rapidly improving business operations as organizations move from complex manual processes to greater efficiency, which also helps improve provider and member satisfaction.  

HealthRules Payer Gets High Marks for ROI and Ease of Use 

Insights from the KLAS research showed several notable trends among HealthRules Payer customers beyond the #1 ranking in the category. The solution received high ratings for “Money’s Worth,” or return on investment, and the top rating from customers was for its “Ease of Use.” For overall satisfaction, the solutions ratings increased year over year. To access the full report and more insights, visit the Best in KLAS website.  

“HealthEdge is positioned in the center of the most critical systems that enable health plans to adapt, expand, and make healthcare work better for everyone,” highlighted Alan Stein, Chief Product and Strategy Officer at HealthEdge. “The voice of our customers is vital to our focus on continuous improvement in our company and our product. We’re honored to be a part of this important research and to receive the support and partnership of our customers.” 

HealthEdge Customers Surveyed 

KLAS evaluations provide quantitative feedback and benchmarks as well as anonymized quotes as qualitative feedback, including the following:  

“One of HealthRules Payer’s strengths is its usability across claims, customer service, appeals and grievances, and providers. There is natural language in the system. Because of HealthRules Payer’s ease of use, we saw a very rapid acceptance of the new system, meaning that productivity returned to normal within a few months. That is not normal when transforming to a completely new platform. We had minimal disruption.” — COO, September 2023 

“We have seen HealthEdge really step up in the AI space. I think there is a lot of movement with the system to really leverage AI and other things.” CTO Nov 2023 

“The platform's configuration, adaptability, and flexibility have benefited our business. The vendor has natural language in regard to benefit configuration, and that has helped our call center. We had a situation during the COVID-19 pandemic where some things needed to be updated, and HealthEdge was able to do that in a very short time frame. In our old system, that would have taken a couple of weeks. Our adjudication rates are very good. We weren't able to achieve those rates with our other system. From a business perspective, it appears that the vendor has a lot of strength when it comes to configurations and claims, and that has helped them make business areas look good and be successful.” — VP, March 2023 

Read the full KLAS report here 2024 Best in KLAS Awards - Software and Services. 

About KLAS 

KLAS is a research and insights firm on a global mission to improve healthcare. Working with thousands of healthcare professionals and clinicians, KLAS gathers data and insights on software and services to deliver timely reports and performance data that represent provider and payer voices and act as catalysts for improving vendor performance. The KLAS research team publishes reports covering the most pressing questions facing healthcare technology today, including emerging technology insights, that provide early insights on the future of healthcare technology solutions. KLAS also fosters measurement and collaboration between healthcare providers and payers and best practice adoption. Learn more at klasresearch.com.