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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

Member Experience

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 Gains

“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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Executive Summary: 2022 Annual Market Survey

November 1, 2022

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New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Gains

Executive Summary: 2022 Annual Market Survey

IDC MarketScape: U.S. Patient Engagement and Enablement Technology 2024–2025 Vendor Assessment

IDC MarketScape: U.S. Care Coordination Technology 2024–2025 Vendor Assessment

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Executive Summary: Effective Care Management for a Complex Market