Data Sheet: Source 3rd Party Integrations Partnerships

Payment Integrity Integrations

Stand-alone third-party solutions integrate individually with claims systems and communicate results differently, leading to payment inaccuracies and a lack of transparency. Some third-party applications are distributed as on-premise software or cobbled-together hosted solutions, making it difficult to stay current with industry updates.

HealthEdge Source™ (Source) offers an integrated ecosystem designed to enhance payment accuracy and transparency by incorporating third-party solutions into a cohesive workflow. This approach not only manages and synchronizes all third-party content updates, but also handles the administrative burden, eliminating IT maintenance.

By partnering with industry leaders, Source enhances its native payment integrity capabilities with specialized services in precision medicine and high-cost drug billing. This strategy ensures that niche services are accurately captured and integrated, thus improving payment integrity.

The benefits of Source's integrated approach include:

• Zero IT Lift: No additional IT hardware or maintenance is required.
• Cohesive Workflow: Unifies native and third-party solutions to provide comprehensive payment guidance.
• Automated Processes: Configured decision-making streamlines reviews and reduces manual labor.
• Efficient and Transparent Operations: Automated repricing and audit trails ensure accuracy and efficiency.
• Inclusive Solutions: Incorporates best-of-breed third-party services for comprehensive cost avoidance.

Compared to the traditional stand-alone approach, Source's integrated ecosystem reduces inaccuracies, rework, and miscommunication, resulting in increased operational efficiency, reduced administrative costs, and improved payment accuracy. This modern solution addresses the challenges faced by health plans, offering a robust and forward-thinking alternative in the realm of payment integrity integrations.