The healthcare industry is at an intersection of technology, artificial intelligence (AI), and operational efficiency. For payers, ensuring provider data integrity is fundamental to scaling...
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HealthEdge®, a leading provider of next-generation core administrative processing systems, payment integrity, and care management solutions, has been recognized as a Sample Vendor in two categories of
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Accurate and reliable data is the backbone of efficient healthcare operations, facilitating key operations—from claims processing to enhanced member engagement. Yet, for many health plans,...
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The healthcare industry is entering a critical phase of reinvention. Legacy technologies and decades-old operational models are no longer sufficient in today’s complex, data-rich, and high-demand...
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Improving health equity starts with recognizing that many people face avoidable barriers to care, such as limited community resources, communication challenges, financial instability...
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GuidingCare Letters is an integrated feature within GuidingCare that streamlines the creation of personalized, compliant member communications, including real-time and batch correspondence.
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Provider data is the backbone of operational efficiency for health plans. From ensuring accurate claims processing to improving member satisfaction, maintaining an up-to-date and reliable provider...
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A payer’s ecosystem is large, complex, and constantly evolving. HealthEdge’s goal is to develop a thriving platform-based ecosystem that allows payers to flexibly weave...
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Health plan executives are pursuing integrated platform solutions that provide better access to data, leading to better member outcomes.
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Leveraging our modern, web-based platform, the new web UI enhances usability, and aligns with industry standards for cloud-based healthcare systems.
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The healthcare industry has long been a primary target for cyberattacks due to the vast amount of sensitive data it handles. The increasing prevalence of cyber incidents, combined with...
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Health plans often face challenges during contract negotiations due to disparate data sources, complex configurations, and manual processes. The reliance on estimates rather than precise data can lead
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