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Data Sheet: HealthRules Payer + Source Integration

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Modern Claims Administration and Payment Integrity

HealthEdge's HealthRules® Payer and Source solutions combine modern claims administration with advanced payment integrity to revolutionize the healthcare industry. HealthRules Payer is a next-generation core administrative processing system that leverages the patented HealthRules Language™ for exceptional claims processing and transparency. Source, HealthEdge’s payment integrity solution, brings payment closer to the point of service while eliminating inefficiencies and enabling informed business decisions through powerful analytics.

Unmatched Capabilities in Claims Processing and Payment Integrity

Together, HealthRules Payer and Source offer unrivaled capabilities in claims processing and payment integrity. This integrated solution enhances automation, improves workflow efficiencies, and boosts claims processing accuracy. Key features include:

  • Single Source of Truth: Combines HealthRules Language with a single priced/edit call for industry-leading claims accuracy.
  • Increased Accuracy: Pricing and editing content libraries are automatically updated every two weeks, with comprehensive access to claims history for history-enabled editing.
  • Organization-Wide IT Lift: Native integration delivers lowered IT requirements and risk through a combined deployment.
  • Improved Payment Integrity: Provides a comprehensive, holistic view of the payment integrity ecosystem with the ability to edit at multiple points in the adjudication workflow.

The combined value of HealthRules Payer and Source not only enhances operational efficiency but also delivers a comprehensive, holistic view of the payment integrity ecosystem. With industry-leading claims accuracy and a robust, streamlined support model, HealthEdge is committed to transforming healthcare through disruptive technology and innovative solutions.

Learn more about how HealthEdge’s integrated solutions can enhance your operational efficiency and competitive edge in the healthcare industry by visiting our website.