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Data Sheet: HealthEdge® AI - Transforming Operations and Care Delivery Through Advanced AI Capabilities

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Transforming Healthcare with HealthEdge AI

HealthEdge AI is revolutionizing the healthcare sector by empowering health plans with advanced artificial intelligence (AI) to enhance care delivery, optimize operational efficiency, and elevate member experiences. Designed for health insurers aiming to thrive in an increasingly competitive and data-driven landscape, HealthEdge offers cutting-edge AI solutions that improve decision-making, reduce costs, and streamline processes.

Key Highlights and Benefits of HealthEdge AI

1. AI-Driven Healthcare Vision:

  • HealthEdge’s vision is to accelerate AI-powered innovations in healthcare, ushering in a future that improves cost and care outcomes while enabling members to live their best lives.

2. Strategic Focus Areas:

  • Intelligent Claims Operations: Automate every aspect of claims adjudication with AI, including contract management, adjudication, fraud detection, and improved financial accuracy.
  • Proactive & Integrated Care: Improve care and cost outcomes while driving care team quality and efficiency through predictive insights, automation and tailored care support.
  • Elevated Member & Provider Experiences: Enable personalized experiences at scale to meet member and provider needs across intelligent content, workflows, and data.

3. HealthEdge’s Responsible AI Development Approach:

  • AI Principles: HealthEdge aligns with emerging healthcare industry healthcare AI principles, coalitions and frameworks such as the published Healthcare AI Commitments and the guidelines of the Coalition for Health AI (CHAI™) to ensure safety and equity for our customers.
  • Responsible AI: Our dedicated enterprise AI risk governance (regulatory, safety, security, ethics/bias, privacy, transparency, fairness, etc.) incorporates frameworks such as the Artificial Intelligence Risk Management Framework (AI RMF 1.0) published by the National Institute of Standards and Technology (NIST) within the U.S. Department of Commerce.
  • Collaboration & Partnership: HealthEdge fosters strong partnerships with customers, end users, and industry stakeholders to develop innovative AI-enabled solutions aligned to the evolving needs of our customers.
  • Operational Value: HealthEdge is committed to developing AI-enabled features that generate meaningful outcomes for health plans, empowering them to adapt and evolve with dynamic market changes and demands.

Why Choose HealthEdge?

HealthEdge combines cutting-edge innovation with a commitment to responsible technology adoption. By balancing automation with operational value, HealthEdge enables health plans to stay ahead of market challenges while enhancing trust, transparency, and collaboration.

Take the Next Step

Equip your organization with enterprise-grade solutions that deliver measurable results. Transform the healthcare experience for your members and redefine how your health plan operates with HealthEdge.

Discover more about HealthEdge's solutions and request a consultation today.