Data Sheet: What Sets Us Apart - Integration Comes Easy
Although a next-generation core administrative system is the heart of a health plan’s ecosystem,there are many systems and applications that need to be integrated together to become a total solution.
In a rapidly evolving healthcare payer market, HealthRules® Payer Solution Suite stands out for its seamless integration capabilities. Designed to simplify complex health plan operations, the suite is powered by the English-like HealthRules Language™, enabling precise expression and transformation of unique health plans.
HealthEdge recognizes that a next-generation core administrative system is essential but not sufficient on its own. Integration with various systems and applications is crucial for creating a comprehensive, efficient ecosystem. Real-time data exchange across stakeholders, including members, providers, groups, pharmacies, and brokers, is essential for reducing errors and maximizing impact.
The HealthRules Payer Solution Suite offers robust real-time transactional capabilities, ensuring efficient data exchange, reduced administrative burden, and enhanced business partnerships. The XML-based web services eliminate the need for understanding complex database schemas or APIs, making integration straightforward and efficient.
Key features include:
- HealthRules Connector for enterprise-class integration.
- Upgrade Assurance to maintain custom code functionality after software updates.
- Automated Testing to proactively identify and address issues.
- Claims Editing and Payment Integrity for high adjudication accuracy.
- HealthRules EDI Gateway for converting EDI files.
HealthRules Payer provides a unified platform for financial, administrative, and clinical operations, ensuring faster implementation, lower integration costs, and compliance with HIPAA requirements. This modern, integrated approach helps health plans stay competitive and responsive in an industry where outdated technology can lead to inefficiencies and increased costs.
By choosing HealthRules Payer, health plans can achieve accelerated time to market, enhanced provider and member satisfaction, and a future-proof system that adapts to the demands of modern healthcare.
