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

Experts in managing complex CMS data for over 25 years. Partnering with top payers for 10+ years.

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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.

About the Author

Christopher Walker is the Product Marketing Manager at HealthEdge for the Payment Integrity solution, Source. Specializing in data-driven strategies, integrated analytics, and competitive intelligence, Christopher crafts messaging that helps healthcare providers and payers improve operational efficiency, reduce member costs, and enhance health outcomes.

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