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The HealthRules® Solutions Suite includes the industry’s leading digital claims administration processing system – plus a host of additional value-added capabilities.
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GuidingCare®, our Care Management Workflow solutions, starts with the nation’s most widely adopted care management platform – and provides much more to improve quality of care.
Guidingcare Solution Suite

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Source is the preeminent digital prospective payment integrity solution, combining claim payment automation with proactive business intelligence.
Source Solution Suite

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Wellframe Digital Care Management and Digital Customer Service solutions extend the reach of your staff to more fully engage and support members.
Wellframe Solution Suite

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New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

“Operating margin improvement is a top three critical outcome for digital investments in 2024 for 67% of U.S. healthcare payers.”

– Gartner®, Three Operational Excellence Best Practices to Optimize Costs for U.S. Healthcare Payers, 1 November 2023, Mandi Bishop 1

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How payers can use integrated data and better analytics to improve claims reimbursement and quality of care

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New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

How payers can use integrated data and better analytics to improve claims reimbursement and quality of care

Top 6 AI Trends in Payment Integrity for Detecting and Preventing Fraudulent and Inaccurate Claims Payments

HealthEdge Source Demo

How Health Plans Can Use Advanced Analytics to Address Common Challenges

Video: HealthEdge Source™ Analytics Overview

Top 5 Payment Integrity Trends Health Plans Should Respond To For 2025

Infographic: HealthEdge Source™ Product Overview

Data Sheet: HealthEdge Source™ Product Overview

Data Sheet: HealthEdge Source™ - Medi-Cal Reimbursement

Improve Pre-Pay Accuracy with Prospective Payment Integrity Solution

Infographic: ACE Your Claims with Advanced Custom Edits from HealthEdge Source™

HealthEdge Source™ Webinar: Advanced Editing - Build Custom Edits & Take Control of Business Rules

Data Sheet: Take Control of Claims Editing with Advanced Custom Edits from HealthEdge Source™

HealthEdge Source™: Advanced Custom Edits

How to Streamline Claims Operations with FAIR Health Integration into HealthEdge Source

HealthEdge Source: Optimizing Retroactive Configuration Changes

HealthEdge Source™ Horizons: Improve Payment Accuracy and Efficiency with Advanced Automation

Infographic: The History of HealthEdge Source™ The Payment Accountability® Platform

HealthEdge Source: Data Reference Module

White Paper: A New Paradigm in Payment Integrity - Taking an Enterprise Approach

Infographic: EDGEcelerate