Case Study: How One Regional Health Plan Created a Member-Centric Digital Ecosystem
Health plan executives are pursuing integrated platform solutions that provide better access to data, leading to better member outcomes.
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See how over 450 health plan leaders are preparing for 2025!
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Case Study: SummaCare's Secret to Payment Integrity Success
Learn about SummaCare's journey to streamlined operations, improved payment accuracy, and enhanced provider transparency.
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"All of our pricing and editing is a one stop shop"
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- Melissa Rusk, VP of Operations, SummaCare -
Case Study:Transforming Payment Accuracy and Operational Efficiency at a Large National Health Plan
Discover how one health plan enhanced efficiency, accuracy, and transparency through with HealthEdge Source.
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Infographic: Top 5 Payment Integrity Trends
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Improve Data Security & Compliance with a Prospective Payment Integrity System
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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Webinar: Transform Contract Negotiations with Data-Driven Insights
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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HealthEdge HealthRules Payer- IMPACT Winter 2024
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HealthEdge Source - IMPACT Winter 2024
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Infographic: HealthEdge Annual Planning Report 2025
Explore key priorities, investments, and challenges facing health plan executives in the coming year.
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Top 6 AI Trends in Payment Integrity for Detecting and Preventing Fraudulent and Inaccurate Claims Payments
Artificial Intelligence (AI) is transforming payment integrity in the health insurance industry, particularly in detecting and preventing fraudulent payments and waste. As fraudulent claims become...
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HealthEdge Source Demo
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How Health Plans Can Use Advanced Analytics to Address Common Challenges
Health plan administrators must adhere to the complex guidelines related to payment integrity, operational efficiency, and regulatory compliance. The claims process is intricate, and the sheer...
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Video: HealthEdge Source™ Analytics Overview
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Top 5 Payment Integrity Trends Health Plans Should Respond To For 2025
Healthcare regulations continue to evolve, reshaping how health plans operate and do business in a competitive market. Amid rising costs and regulatory pressures, healthcare fraud prevention is...
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Infographic: Transform Your Claims Processing with Pre-Pay Model
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Data Sheet: HealthEdge Source™ Product Overview
HealthEdge Source™ (Source) is a cloud-based solution designed to revolutionize payment accuracy and integrity in the healthcare industry.
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Data Sheet: HealthEdge Source™ - Medi-Cal Reimbursement
A prospective payment integrity solution that manages accurate and compliant pricing data, so health plans don’t have to.
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Improve Pre-Pay Accuracy with Prospective Payment Integrity Solution
The traditional post-pay model has long been the standard in healthcare claims adjudication. However, it can result in significant administrative burdens and increased costs for healthcare payers....
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Infographic: ACE Your Claims with Advanced Custom Edits from HealthEdge Source™
Introducing Advanced Custom Edits from HealthEdge Source™, a new feature designed to expedite and streamline the claims editing process.
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HealthEdge Source™ Webinar: Advanced Editing - Build Custom Edits & Take Control of Business Rules
HealthEdge Source™ (Source) recently hosted a training webinar focusing on the latest enhancements to the Custom Edit tool.
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