Member Experience

Data Sheet: Achieving Transparency Compliance Through HealthRules Payer

Achieving regulatory compliance in the healthcare industry is a complex and evolving challenge, particularly with mandates such as the Transparency in Coverage (TIC) Final Rule and the No Surprises Ac

Consumer Survey Satisfaction Insights Report 2023

Data Sheet: Point-of-Service (POS) Payment Success in Healthcare - Process Automation & Intelligent Workflows

What if we could develop a smart and efficient workflow that ensures payment accuracy from the start?

Data Sheet: GuidingCare Medication Therapy Management

The Importance of Medication Therapy Management

Data Sheet: GuidingCare Appeals & Grievances

Meet Regulatory demands and ensure compliance with GuidingCare Appeals & Grievance.

Data Sheet: What Sets Us Apart - Actionable Insights for the Business

One of the major challenges for any health plan is to provide robust, comprehensive, and actionable data to key stakeholders in the healthcare continuum.

Data Sheet: Care Payer Integration

Care-Payer leverages the openness and flexibility of GuidingCare® and HealthRules® Payer to give care and utilization managers, providers, customer service representatives instant access to insights.

Case Study: McLaren Health Plan

For McLaren Health Plan, outdated 30-year-old technology was resulting in a zero percent claims auto-adjudication rate, after switching to HealthRules Payer they are now exceeding 90 percent.

Case Study: Friday Health Plans

As the next-generation core administrative system that runs Friday Health Plans’ operation, HealthRules Payer is built for growth, reliability, and customer excellence.

Case Study: Independent Health

Paying for value continues to gain momentum in the industry. This presents significant challenges, and interesting opportunities, for health plans.