HealthEdge AI

How Can AI-Powered DRG Editing Improve Claims Accuracy? 

Claims inaccuracy has long been a pain point in the healthcare industry. Processing inefficiencies lead to challenges like payment delays, retroactive changes, damaged member and provider...

HealthEdge Recognized as a Sample Vendor in 2025 Gartner® Hype Cycle™ for Provider Data Management and AI-Enabled Fraud Detection

HealthEdge®, a leading provider of next-generation core administrative processing systems, payment integrity, and care management solutions, has been recognized as a Sample Vendor in two categories of

The Opportunity for AI Transformation in Healthcare 

Artificial intelligence (AI) is moving beyond the experimental phase, and its applications are certainly no longer reserved for very large enterprises. In healthcare, applying AI to improve...

Transform Health Plan Operations with AI-Powered Core Administration 

Artificial intelligence (AI) has become the catalyst for transformation across various industries, and healthcare is no exception. For health plans, the integration of AI is no longer just a...

Consumers Split on Health Insurance as ‘Partner’ or ‘Payer’ According to HealthEdge Research

HealthEdge Surveys of 4,500+ Consumers Measures Public Perception of Health Insurance and Reveals Gaps and Opportunities for AI to Transform Member Experience

Improve Care Coordination and Delivery with AI & HealthEdge GuidingCare®

Healthcare is undergoing a transformation, and artificial intelligence (AI) is a major part of this evolution. From improving diagnostic accuracy to transforming care coordination workflows, AI...

HealthEdge Sets Course to Become an AI-Native Enterprise with Enterprise-Wide Migration to AWS

Building a More Intelligent Payment Integrity Process: AI Enhancements in HealthEdge Source

In a recent webinar, two HealthEdge Source™ product leaders demonstrated how our teams are integrating artificial intelligence (AI) into our solutions to enhance experiences and outcomes for...

Comprehensive AI Glossary: Key Terms for Payers Explained

Dive into our AI glossary tailored for health plans and payers. Learn essential terms like Machine Learning, Generative AI, and NLP to understand their impact on healthcare operations and payer...

How the HealthEdge® AI Summarizer Empowers Teams to Deliver Personalized Care at Scale

Care managers are responsible for far more than delivering care. They coordinate member communication, update health records, navigate program changes, and play a crucial role in ensuring...

HealthEdge and Gynisus Bring AI-Powered Clinical Precision to Payment Integrity

Proven Agentic AI Model Powered by Gynisus Adds Speed and Accuracy to Adjudicating Claims for Coding Errors, Clinical Integrity and Medical Necessity

HealthEdge Launches AI-Driven Provider Data Management Solution to the Market

Creating a Culture of Innovation to Accelerate AI Adoption

Artificial Intelligence (AI) is transforming healthcare by helping payers streamline operations, reduce costs, and enhance experiences for staff, members, and providers. However, health plans must...