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

HealthEdge Source™ The Payment Accountability® Platform History

The HealthEdge Source™ The Payment Accountability® Platform has evolved significantly since its inception, establishing a robust solution for managing complex CMS data and claims reimbursement processes. Here is a brief timeline highlighting key milestones and achievements:

Milestones:

1. 1997 - Medicare Fee Manager: Burgess Group introduced a centralized warehouse to model and download CMS fee schedules, simplifying the adjudication process.
2. 2008 - CMS Award: Recognized by CMS as the claims reimbursement solution for settling payment disputes under the Medicare Advantage program.
3. 2017 - Launch of Burgess Source®: Introduced a first-of-its-kind platform for contract configuration, editing, pricing, and analytics.
4. 2019 - Gartner Hype Cycle® Recognition: Source was recognized as a vendor partner in the category of Prospective Payment Integrity.
5. 2022 - Retroactive Change Manager: Launched Retroactive Change Manager, helping payers achieve approximately 1.5% medical savings on claims impacted by CMS/Medicaid retroactive changes.
6. 2023 - Gartner and KLAS Recognitions:
   • Gartner recognized HealthEdge in AI Fraud Detection Enablement and Prospective Payment Integrity for the fifth consecutive year.
   • KLAS published a spotlight on HealthEdge Source and named it a top Payment Integrity vendor.

Key Dates:

• 2006 - Process Automation: Automated claims editing and pricing for Government and Commercial programs.
• 2011 - Burgess Reimbursement System (BRS®): Launched web-based claims pricing software, pioneering bi-weekly CMS and Medicaid updates.
• 2020 - Merger with HealthEdge Software, Inc.: Merged with HealthEdge to deliver an end-to-end unified claims processing solution.
• 2023 - Payer-Source Integration: Launched integration for secondary editing, achieving approximately 1-3% medical savings.

Performance Metrics:

• 200ms average processing time for claim pricing and editing
• 99% uptime achieved for clients
• 144MM claims processed across 30+ customers
• 1,800 policy updates for payment accuracy in 2023
• 375K production claims processed per day
• 22 successful implementations of Source features in 2023

HealthEdge Source™ The Payment Accountability® Platform continues to lead the industry with its innovative solutions, providing payers with the tools they need to pay claims accurately, quickly, and comprehensively the first time.