HealthEdge Software Inc.
The healthcare industry is at an intersection of technology, artificial intelligence (AI), and operational efficiency. For payers, ensuring provider data integrity is fundamental to scaling...
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Three months ago, I posed a question to our engineering leadership team: “What if we could use AI tools eliminate the mundane and amplify human creativity in every phase of software development?”...
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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...
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Health plan executives face increasing demand to deliver frictionless experiences, from streamlined operations to a modern member experience, to stay competitive in a rapidly evolving market. At...
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Healthcare consumers are increasingly demanding choice and control, and health plans are under growing pressure to adapt. In the 2025 HealthEdge® Healthcare Consumer Study, 60% of individuals with...
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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...
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Accurate and reliable data is the backbone of efficient healthcare operations, facilitating key operations—from claims processing to enhanced member engagement. Yet, for many health plans,...
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HealthEdge® recently released its fifth annual Healthcare Consumer Study, one of the most comprehensive consumer surveys in the health insurance industry. This year, more than 4,500 healthcare...
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Table of Contents Top 5 Challenges in Managing Medicaid Programs The Consequences of Falling Behind in Medicaid Offerings Solve Key Medicaid Challenges with Advanced Payment Integrity The...
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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...
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Quality performance expectations have reached a turning point in 2025. This year’s Healthcare Effectiveness Data and Information Set (HEDIS) measures, developed and maintained by the National...
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Your health plan is constantly growing and expanding—and your digital ecosystem should be able to keep pace and scale with your organization. Whether your health plan is adding new lines of...
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Health plan executives face increasing demand to deliver frictionless experiences, from streamlined operations to a modern member experience, to stay competitive in a rapidly evolving market. At...
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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...
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The digital transformation of healthcare has fundamentally shifted member expectations. Today’s members expect more than convenience. They want clarity on their care, real-time access to guidance,...
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The healthcare industry is entering a critical phase of reinvention. Legacy technologies and decades-old operational models are no longer sufficient in today’s complex, data-rich, and high-demand...
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Health plans face evolving industry dynamics that demand quick action and measurable outcomes. Rising member expectations, regulatory requirements and financial considerations all point toward the...
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The healthcare payer market is at a critical juncture, driven by increasing market pressures, consumer demands, and the need for technological modernization. At HealthEdge®, we believe payers have...
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Healthcare is at a crossroads. Legacy platforms, endless point solutions, and mounting regulatory pressure are all warning signs on the road to change. The need for transformation is clear, even...
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For modern health plans, enhancing auto-adjudication rates is more than a technical upgrade. It is a strategy for payers aiming to stay competitive by increasing automation, improving efficiency,...
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