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The "Edit Smarter, Not Harder" webinar, led by Carl Anderson, showcased how HealthEdge Source makes managing edits easier and more efficient for health plans. The session highlighted tools like Advanc
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See how over 450 health plan leaders are preparing for 2025!
Learn MoreMaintaining efficient claims processing workflows can become an overwhelming task for many health plans. Claims teams have to process every claim accurately and on time, keep up with changing...
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"All of our pricing and editing is a one stop shop"
- Melissa Rusk, VP of Operations, SummaCare
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Dive into some of the toughest challenges in payment integrity and explore actionable strategies to overcome them using advanced solutions.
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Claims inaccuracy has long been a pain point in the healthcare industry. Processing inefficiencies lead to challenges like payment delays, retroactive changes, damaged member and provider...
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In a recent webinar, two HealthEdge Source™ product leaders demonstrated how our teams are integrating artificial intelligence (AI) into our solutions to enhance experiences and outcomes for...
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Proven Agentic AI Model Powered by Gynisus Adds Speed and Accuracy to Adjudicating Claims for Coding Errors, Clinical Integrity and Medical Necessity
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Streamline claims processing and enhance payment accuracy with HealthEdge Source™ Platform Access.
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What does it take to pay a claim correctly? In healthcare, “editing claims” goes beyond surface-level checks—it’s about ensuring accuracy, compliance, and efficiency. Each claim must align with...
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In our "Path to Payment Integrity" webinar, we discussed the biggest challenges in claims payment accuracy, including complex regulations, reliance on recovery vendors, high administrative costs, and
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If you’re responsible for managing a health plan, you’ve probably felt the strain of payment processes that don’t work as they should. Payment errors pile up, outdated systems slow you down, and...
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For health plans, payment errors and discrepancies aren’t just frustrating—they can be costly. Without access to updated pricing information, health plans face payment delays and inaccuracies that...
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To stay ahead of complex payment models and billing guidelines, healthcare payers are turning to integrated digital solutions that can help streamline operations to achieve key business goals....
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Health plans face a variety of challenges when it comes to contract modeling, negotiations, and reviews. A reliance on manual processes and disparate tools can make it difficult to accurately...
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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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