Data Sheet: Custom Code Services for HealthEdge GuidingCare®
Explore how the Global Professional Services team partners with health plans to build custom code solutions across four key service areas.
Comprehensive GuidingCare Services Overview
Health plans depend on HealthEdge GuidingCare® to deliver integrated, member-centered care. Maximizing the platform's value requires more than standard implementation; it demands the ability to customize and evolve the solution to meet specific business needs. HealthEdge’s Global Professional Services (GPS) team provides expert Custom Code Services to help GuidingCare customers build scalable, compliant, and high-performing solutions.
With deep product expertise, our GPS team partners with health plans to optimize workflows, reduce administrative burdens, and drive better health outcomes.
Why Partner with HealthEdge Global Professional Services?
Our GPS team delivers productized services with proven results, grounded in three core principles:
- Deep Product Expertise: Our team consists of experienced business analysts, developers, quality analysts, delivery managers, and subject matter experts with comprehensive knowledge of GuidingCare and the healthcare industry.
- Commitment to Quality: Every engagement includes robust data quality checks and is supported by HealthEdge’s dedicated Production Support team for ongoing assistance.
- Accelerated Time to Value: We apply proven methodologies and maintain direct access to HealthEdge product engineers, enabling us to deliver rapid, high-quality solutions.
Comprehensive Custom Code Services for GuidingCare
The GPS team offers tailored Custom Code Services across four key areas to enhance and extend the functionality of your GuidingCare platform.
Business Rules & Workflow Automation
Every health plan operates with unique clinical guidelines, regulatory requirements, and operational workflows. While GuidingCare offers powerful built-in automation, many customers require custom business rules to reflect their specific organizational nuances. Our GPS team partners with you to design and deploy business rules that automate complex care management workflows with precision.
What We Deliver:
- Requirements gathering and business analysis
- Custom rule design and development
- Testing and quality assurance
- Deployment into the GuidingCare environment
- Ongoing maintenance and support
Customer Impact: A health plan struggling with inefficient authorizations saw a 50% improvement in their auto-authorization rate after GPS developed custom business rules. This enabled 20,000 automated approvals annually, freeing up valuable clinical resources.
Learn more about our approach to Business Rules & Workflow Automation.
Letters & Member Communication
No two health plans communicate with members in the same way. Branding, regulatory language, and member population characteristics shape how correspondence is structured and delivered. The GPS team provides end-to-end support to help customers design, automate, and scale personalized Letters & Member Communication that reflect their unique operational needs.
Our Correspondence Services:
|
Service Component |
Description |
|
Analysis |
Business requirements and template analysis. |
|
Development |
Creation of complex correspondence rules and standardized, automated letter templates. |
|
Integration |
Seamless integration with mail and fax vendors. |
|
Validation |
Rigorous testing of templates and workflows. |
|
Optimization |
Ongoing support and enhancement of communication processes. |
Customer Impact: One plan managed over 1,200 letter templates, creating significant scalability and compliance challenges. GPS helped consolidate them into 250 templates—an 80% reduction—which enabled easier maintenance, better reporting, and improved member communication.
Interfaces & Data Exchange
Care teams rely on accurate, up-to-date data, but much of that information often resides in systems outside of GuidingCare. The GPS team builds secure and automated Interfaces & Data Exchange solutions, eliminating manual work and improving data accuracy across platforms.
What We Deliver:
- Integration planning and data mapping
- Data extraction, transformation, and enrichment
- Secure data loading into GuidingCare
- Testing and validation of data quality
- Ongoing support and troubleshooting
Customer Impact: A health plan wanted to incorporate Social Determinants of Health (SDOH) data from community partners. GPS built interfaces to extract, standardize, and load this data into GuidingCare. The result was a centralized, up-to-date view of key SDOH factors, enabling more informed care planning and better coordination.
Reporting & Insights
While GuidingCare offers a set of pre-built reports, many organizations require customized views and metrics that align with their specific programs and goals. The GPS team works with customers to build tailored Reporting & Insights solutions to ensure you get the right information, at the right time, and in the right format.
What We Deliver:
- Requirements gathering and schema documentation
- Report design consultation and database navigation
- Setup of a replicated reporting database for performance
- Testing and validation of reporting outputs
- Ongoing maintenance and enhancement
Customer Impact: GPS helped a health plan create tailored reports to monitor population health trends and personalize care. The new reports identified care gaps, chronic condition trends, and social risk factors, enabling more targeted care planning and smarter resource allocation.
Enhance Your GuidingCare Experience with Optimization & Professional Services
Whether you need to automate workflows, streamline member communications, or extract richer insights from your data, the HealthEdge Global Professional Services team is ready to help. We work with you to configure GuidingCare to meet your goals—today and as your needs evolve.
Start by learning how to enhance your technology systems with our Optimization & Professional Services.
