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The HealthRules® Solutions Suite includes the industry’s leading digital claims administration processing system – plus a host of additional value-added capabilities.
Healthrules Solution Suite

Care Management Workflow Solutions

GuidingCare®, our Care Management Workflow solutions, starts with the nation’s most widely adopted care management platform – and provides much more to improve quality of care.
Guidingcare Solution Suite

Prospective Payment Integrity

Source is the preeminent digital prospective payment integrity solution, combining claim payment automation with proactive business intelligence.
Source Solution Suite

Member Experience

Wellframe Digital Care Management and Digital Customer Service solutions extend the reach of your staff to more fully engage and support members.
Wellframe Solution Suite

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New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

“Operating margin improvement is a top three critical outcome for digital investments in 2024 for 67% of U.S. healthcare payers.”

– Gartner®, Three Operational Excellence Best Practices to Optimize Costs for U.S. Healthcare Payers, 1 November 2023, Mandi Bishop 1

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Case Study: SummaCare - How consumerism is driving SummaCare's digital transformation

March 6, 2023

New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Case Study: SummaCare - How consumerism is driving SummaCare's digital transformation

Data Sheet: HealthEdge Source™ - Medi-Cal Reimbursement

Data Sheet: HealthRules® Payer Named “Best in KLAS®” Three Years in a Row

Data Sheet: HealthEdge Source: Software for Health Plans With Home & Host Capabilities

Case Study: Summacare - What does being a digital health plan mean to you?

Case Study: SummaCare - What makes Source different

Case Study Q&A Video: SummaCare & HealthEdge Source Partnership

Data Sheet: HealthRules® Payer named “Best in KLAS” in 2023 Research Report (PDF)

White Paper: Prospective Payment Integrity Solution Partner

Brochure: Prospective Payment Integrity

Case Study: Medica’s Business Transformation

Case Study: Friday Health Plans