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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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Data Sheet: HealthEdge Source™ Medicaid - Missouri

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3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Data Sheet: HealthEdge Source™ Medicaid - Missouri

Expanding Payment Integrity Through Seamless Integrations | HealthEdge Source™ Third-Party Ecosystem

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Data Sheet: Ecosystem Enablement - GuidingCare Partner Integrations

Data Sheet: Next-Generation Core Administrative Processing Systems (CAPS)

Data Sheet: Provider Data Management Frequently Asked Questions

Data Sheet: Provider Data Management - Commitment to Security and Data Protection

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Data Sheet: Drive Data Integrity and Reliability with Provider Data Management

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HealthEdge® Machine Readable Files Suite for HealthRules® Payer

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