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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.
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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

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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: Stay Ahead of a Shifting Regulatory Landscape with Provider Data Management

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3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Data Sheet: Stay Ahead of a Shifting Regulatory Landscape with Provider Data Management

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)

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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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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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