Medicare

Configuration as a Service Expedites Time-to-Value for Health Plans

HealthEdge's Configuration as a Service optimizes HealthRules® Payer system configurations, accelerating time-to-value for health plans.

Source: Our Work With Plans Offering Home & Host Capabilities

How Plans with Home and Host Capabilities Lead in Value-Based Care

In our work with HealthRules® Payer clients, we have gained first-hand experience, supporting these plans with the technology they need to lead value-based care and healthcare transformation.

Differentiator Resiliency to Change

Platform Access Delivers a Transformative Approach to Payment Integrity

Optimize Payment Accuracy with History-Based Editing

HealthRules® Payer named “Best in KLAS®”

HealthRules Payer has been named “Best in KLAS” by KLAS Research for Claims & Administration Platforms for the second year in a row.

Prospective Payment Integrity Moving from Pay and Chase to Predictive

This Spotlight examines payer payment integrity platforms and how payers can aggressively apply analytics and coordinate workflows to move "left" from reactive postpay to proactive, predictive prepay.

Source Claims Modeling

GuidingCare Utilization Management

HealthRules Payer + Source Integration

GuidingCare Appeals & Grievances

McLaren Health Plan Case Study

Prospective Payment Integrity Brochure

Large, National Health Insurer Case Study

Independent Health Case Study