Government

Configuration as a Service Expedites Time-to-Value for Health Plans

HealthEdge's Configuration as a Service optimizes HealthRules® Payer system configurations, accelerating time-to-value for health plans.

Traditional Claims Editing Vendors vs HealthEdge Source

Source: Our Work With Plans Offering Home & Host Capabilities

How Plans with Home and Host Capabilities Lead in Value-Based Care

In our work with HealthRules® Payer clients, we have gained first-hand experience, supporting these plans with the technology they need to lead value-based care and healthcare transformation.

Source Medicaid Michigan

Source deliveries in-depth MI Medicaid content that includes state-specific fee schedules and payment policies across a wide range of facility and professional provider types.

Differentiator Resiliency to Change

Platform Access Delivers a Transformative Approach to Payment Integrity

Optimize Payment Accuracy with History-Based Editing

HealthRules® Payer named “Best in KLAS®”

HealthRules Payer has been named “Best in KLAS” by KLAS Research for Claims & Administration Platforms for the second year in a row.

The Path to Point-of-Service Payment Success: Integrated Ecosystems

The Path to Point-of-Service Payment Success: Cloud-based Data Delivery

The Path to Point-of-Service Payment Success: Process Automation and Intelligent Workflow

Prospective Payment Integrity Moving from Pay and Chase to Predictive

This Spotlight examines payer payment integrity platforms and how payers can aggressively apply analytics and coordinate workflows to move "left" from reactive postpay to proactive, predictive prepay.

Automatically Manage Retroactive Policy and Pricing Changes

Source Reimbursement: Challenging the Status Quo of Claims Payments