Solutions
Solutions Solutions

Core Administrative Processing System

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

Care Management Workflow Solutions

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

Professional Services Customer Success Care-Payer Integration Payer-Source Integration Partners
Lines of Business
Commercial

Government

Medicaid Medicare Dual-Eligibles

Plans With Home & Host Capabilities

Dental

Consultants
Resources
Blog

Core Admin

Care Management

Payment Integrity

Member Engagement

Professional Services

Case Studies

Regulatory & Compliance

Advanced Automation

New Market Expansion

Value-Based Care

Events

Newsroom

Company News

Press Releases

Help Center

New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

“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

READ BLOG POST
About Us
Leadership

Careers

Life at HealthEdge US Office India Office Employee Testimonials

Job Openings

Infographic: Improving Member Satisfaction

Engage and delight members with a personalized digital experience.

Download PDF

New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Infographic: Improving Member Satisfaction

Infographic: 2024 HealthEdge Annual Payer Market Survey

Infographic: The History of HealthEdge Source™ The Payment Accountability® Platform

Infographic: A Member Journey After the No Surprises Act

Infographic: Future-Proof Claims Editing for Real Savings with Source Editing

Infographic: Health Plan Member Satisfaction - The Current State

Infographic: Secrets of a Successful Care Management Implementation

Infographic: Traditional Claims Editing Software vs. HealthEdge Source

Infographic: The Changing State of Payment Integrity for Health Plans

Infographic: A Fresh Approach to Improving Payment Integrity

Infographic: EDGEcelerate

Infographic: GuidingCare Clinical Expertise

Infographic: Top 9 Reasons More Payers Choose GuidingCare Than Any Other Care Management System

Annual Market Survey Report 2022

Infographic: HealthRules Payer Implementation

Infographic: Digital Payer