Data Sheet: Care Payer Integration
Care-Payer leverages the openness and flexibility of GuidingCare® and HealthRules® Payer to give care and utilization managers, providers, customer service representatives instant access to insights.
The integration of Claims and Care Management through Care-Payer by HealthEdge® offers a revolutionary approach for health plans. By leveraging the synergy between HealthRules® Payer and GuidingCare®, this solution provides seamless connectivity that enhances efficiency and reduces costs.
Key Features
- Real-time Data Access: Ensures immediate availability of member demographics, provider information, claims data, and benefit details.
- Streamlined Workflows: Facilitates the exchange of data between HealthRules Payer and GuidingCare, improving accuracy and eliminating the need for duplicate entries.
- Enhanced Payment Integrity: Improves claims matching and auto-adjudication rates, reducing manual intervention.
- Cost Reduction: Minimizes the development effort required to maintain third-party integrations.
- Improved Outcomes: Increases transparency and data access, leading to better care planning and patient outcomes.
Benefits
- Increased Transparency: Provides key stakeholders with up-to-date, accurate information.
- Improved Care Planning: Enhances patient outcomes by optimizing care management processes.
- Workflow Efficiency: Reduces errors and frustration by connecting core administrative processes with care management platforms.
How It Works
- HealthRules Payer: Offers standardized benefit information for real-time access in GuidingCare.
- GuidingCare: Shares information with HealthRules Payer to streamline claims management and improve accuracy.
The Care-Payer solution is a game-changer for health plans, breaking down silos and creating efficient, connected workflows. To learn more about how your health plan can benefit from Claims and Care Management integration, visit the Care-Payer page.
