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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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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: Provider Data Management - Commitment to Security and Data Protection

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3 Functional Areas That are Ripe for immediate Operational Efficiency Games

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

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

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Data Sheet: HealthEdge Source™ Medicaid - Arizona

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Data Sheet: Ecosystem Enablement - GuidingCare Partner Integrations

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

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Data Sheet: Optimize Efficiencies with Integrated HealthRules Payer Solutions

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HealthEdge® Machine Readable Files Suite for HealthRules® Payer

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