Data Sheet: Advantages of an Integrated Ecosystem

Advantages of an Integrated Ecosystem

The Challenge

In today's healthcare landscape, using stand-alone third-party solutions can often lead to inefficiencies and inaccuracies. These systems typically integrate individually with claims systems and communicate results in different ways, which can cause several issues including:

• Payment inaccuracies
• Increased rework
• Miscommunication

Additionally, the frequent need to update coding, policies, and rates only adds to these problems, creating an administrative burden and disrupting workflows.

Integrated Solutions for Enhanced Efficiency

HealthEdge Source™ addresses these challenges by delivering an integrated ecosystem that brings accuracy and data transparency upstream in the payment process. Our solution incorporates third-party solutions into a cohesive workflow, managing and synchronizing all content updates. This eliminates the need for separate point solutions and reduces administrative overhead.

Unique Advantages of Source's Integrated Ecosystem

1. Zero IT Lift: No additional IT hardware or maintenance, easing the burden on health plans.
2. Cohesive Operations: Combines native and third-party workflows to provide comprehensive payment guidance, ensuring all aspects of the payment process are aligned.
3. Automated Decision-Making: Configured by the health plan to ensure correct claims are sent for review, reducing manual processes.
4. Efficient and Transparent Processes: Automated repricing and comprehensive audit trails enhance claim resolution accuracy and transparency.

Implementing an Integrated Ecosystem Results In:

• Increased operational efficiency
• Reduced administrative costs
• Improved payment accuracy

By leveraging HealthEdge Source's integrated ecosystem, health plans can enhance efficiency, transparency, and accuracy in their payment processes, resulting in streamlined operations and reduced administrative costs.