HealthEdge AI

Scalability Isn’t Just an IT Problem Anymore

Why Health Plans Need More Than Capacity to Compete in an Era of Growth, Complexity, and AI For years, scalability was largely viewed as a technology concern. As long as claims were processing,...

How an AI-Powered Virtual Nurse is Helping Health Plans Scale Care Management 

Key Takeaways HealthEdge® partnered with Ellipsis Health to integrate Sage, an AI-powered voice agent, directly into the GuidingCare® platform—giving health plans a scalable way to automate member...

How HealthEdge® Is Using AI to Transform Health Plan Implementations—From Discovery to Deployment 

Key Takeaways For health plans, the implementation period is one of the highest-risk, highest-stakes phases of any technology investment—and AI can significantly reduce that risk. HealthEdge...

Ethical AI: Bias and Fairness — Practical Steps for Every Role 

This is part 3 of a blog series on Ethical AI. For context on this series and why we’re writing it, see our introduction in part 1, Ethical AI: Privacy and Security. How Can Payers Address Bias in...

Ethical AI: Bias and Fairness — Definitions, Sources, and Challenges 

Introduction This is part 2 of a series on Ethical AI. The content was adapted from an internal learning and development session developed by the Machine Learning Engineers at HealthEdge®, focused...

HealthEdge® Launches Haven, an AI-Powered Nurse Assistant for Health Plans, Embedded in HealthEdge GuidingCare

When Patients Turn to AI First: What It Means for Health Plans 

Healthcare consumers are changing how they seek information, and increasingly, they are turning to artificial intelligence to do it. Tools powered by generative AI, including platforms like...

How NorthWinds Technology Solutions Reached 90% Auto-Adjudication with HealthRules® Payer AI 

Efficiencies in claims processing is a direct driver of cost management, member satisfaction, and competitive positioning. NorthWinds Technology Solutions leadership understood this when they made...

Podcast: Current Trends for Payers - Call Centers in the Age of AI

AI in Healthcare: Why Regulatory Momentum Is a Wake-Up Call for Health Plans 

Artificial intelligence (AI) is no longer a future consideration for health plans. AI-powered tools are already reshaping how organizations operate, how members seek information, and how leaders...

HealthEdge® Partners with Ellipsis Health to Scale Care Management Through AI-Powered Virtual Nursing

Partnership brings autonomous, voice-based member outreach to health plans, to improve efficiency, member engagement and population health outcomes

Ethical AI: Privacy and Security

This is part 1 of a blog series on Ethical AI. This content was adapted from an internal learning and development session developed by HealthEdge’s AI team, focused on educating our organization...

Building Trust in AI: A Guide to LLM Evaluations 

Large language models (LLMs) are inherently probabilistic, meaning the same input can produce different outputs. That variability makes traditional unit tests, which verify exact results,...

Building Trust in LLM Solutions: A Practical Guide to Evaluation Planning 

Artificial intelligence (AI) is fundamentally changing how healthcare software is built. From automated test case generation to intelligent documentation and decision support, large language...