High-Speed Payment Accuracy: Take a Proactive Approach with HealthEdge Source
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See how over 450 health plan leaders are preparing for 2025!
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From Guessing Game to Proactive Process: Payment Integrity with HealthEdge Source™
Managing payments for a health plan is not as simple as it was a few decades ago. Updated billing models, new compliance mandates, and complex provider networks can make it challenging for payers...
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"All of our pricing and editing is a one stop shop"
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Enhance Health Plan Payment Integrity with Integrated AI Tools
Operating within the U.S. healthcare industry can be challenging. Decades of layered regulations, siloed processes, and a sprawling network of stakeholders have created an environment where...
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Case Study: Large Regional Health Plan Achieves Scalable Success with HealthEdge Source™ Services
The HealthEdge Source Professional Services team supported a large regional health plan with their claims process and scaled their operations to meet growing demands.
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How Advanced Payment Integrity Strengthens Transparency and Collaboration Across the Healthcare Ecosystem
Increasing rates of claims denials cause operational bottlenecks and financial consequences across the healthcare system. In 2024, the initial claims denial rate rose to nearly 12%. Denied claims...
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Webinar: Edit Smarter Not Harder with HealthEdge Source™
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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Improve Claims Operations & Efficiency with HealthEdge Source™ Professional Services
Maintaining 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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Infographic: Optimize Your Workflow and Maximize Savings with Integrated Secondary Editing for HealthRules® Payer
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Enhancing Healthcare Payer Efficiency with HealthEdge Source™ Advanced Custom Edits and Analytics Integration
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eBook: Path to Payment Integrity: A Story of Innovation and Impact
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Reimagined Payment Integrity with AI
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Webinar: Driving Payment Integrity with AI-Powered Precision
Dive into some of the toughest challenges in payment integrity and explore actionable strategies to overcome them using advanced solutions.
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How Can AI-Powered DRG Editing Improve Claims Accuracy?
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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Building a More Intelligent Payment Integrity Process: AI Enhancements in HealthEdge Source
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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HealthEdge and Gynisus Bring AI-Powered Clinical Precision to Payment Integrity
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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White Paper: Position Your Health Plan for Long-Term Success with Payment Integrity
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Data Sheet: Redefining Payment Integrity with HealthEdge Source™ Platform Access
Streamline claims processing and enhance payment accuracy with HealthEdge Source™ Platform Access.
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5 Common Barriers to Efficient Claims Management for Health Plans
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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Webinar: Path to Payment Integrity - Enhance Payment Accuracy with HealthEdge Source™ Editing
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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Expanding Payment Integrity Through Seamless Integrations | HealthEdge Source™ Third-Party Ecosystem
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