Brochure: Plans With Home and Host Capabilities - How to Stay Ahead of the Curve
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Plans with Home and Host
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4 Ways Home and Host Plans Stay Ahead with Next-Generation CAPS
Health plans with home and host capabilities have set the standard for healthcare excellence since 1929—but mounting industry pressures constantly challenge these market leaders. Decreasing...
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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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The Hidden Costs of Legacy Core Administrative Processing Systems (CAPS)
Many health plans continue to rely on legacy Core Administrative Processing Systems (CAPS) as the backbone for managing critical operations such as claims processing, benefit configuration, and...
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Infographic: Legacy vs. Next-Generation Core Administrative Processing Systems (CAPS)
As the environment for health plans evolves rapidly, now is the time to modernize CAPS to enhance your ability to compete for members, improve effciencies, and maintain compliance.
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HealthRules® Payer Horizons: Expanding New Business Opportunities
In the swiftly evolving landscape of healthcare, staying ahead demands not just understanding the market but redefining the competition. For health plan leaders, navigating these waters involves a...
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Case Study: HealthRules Payer Case Study with Presbyterian
HealthEdge had the opportunity to sit down with Presbyterian Health Plan leadership to learn more about why their organization decided to make the switch to HealthRules Payer as it's CAPS partner.
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eBook: CMS Transparency in Coverage Rule
The Transparency in Coverage Guide (CMS-9915-F) is a pivotal regulation aimed at increasing transparency in healthcare pricing, enabling consumers to access price information before receiving services
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Data Sheet: Navigating the No Surprises Act - The Right Tools for Health Plan Success
The No Surprises Act (NSA) marks a significant regulatory milestone aimed at protecting consumers from surprise medical bills and enhancing transparency in healthcare.
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Data Sheet: Achieving Transparency Compliance Through HealthRules Payer
Achieving regulatory compliance in the healthcare industry is a complex and evolving challenge, particularly with mandates such as the Transparency in Coverage (TIC) Final Rule and the No Surprises Ac
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Data Sheet: Configuration as a Service Expedites Time-to-Value for Health Plans
HealthEdge's Configuration as a Service optimizes HealthRules® Payer system configurations, accelerating time-to-value for health plans.
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Brochure: Value-Based Care - Health Plans With Home & Host Capabilities Are Market Leaders
In our work with HealthRules® Payer clients, we have gained first-hand experience, supporting these plans with the technology they need to lead value-based care and healthcare transformation.
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Data Sheet: Optimize Payment Accuracy with History-Based Editing
As more contracts and policies shift toward value-based care and billing requirements, evolve, the opportunities for inaccurate payments increase...
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Case Study: SummaCare - Value of Editing & Pricing in Source
The case study highlights the value of pricing & editing using Source, a comprehensive platform that has streamlined vendor solutions for Medicare Advantage employer groups and commercial claims.
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Case Study Q&A Video: SummaCare & HealthEdge Source Partnership
SummaCare Health Plan, based in Akron, Ohio, is a provider-owned health plan with around 62,000 members.
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Data Sheet: HealthRules® Payer named “Best in KLAS” in 2023 Research Report
HealthRules Payer has been named “Best in KLAS” by KLAS Research for Claims & Administration Platforms for the second year in a row.
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Data Sheet: Point-of-Service Payment System Success - Integrated Ecosystems (PDF)
Traditional claims systems are often fragmented and inefficient, leading to significant errors and unnecessary operational costs.
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Data Sheet: Cloud-Based Data Delivery in Healthcare — Point-of-Service Payment Success Path
In today's healthcare landscape, the complexity and inefficiencies of payment systems are a common source of frustration for patients, providers, and payers alike.
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Data Sheet: Point-of-Service (POS) Payment Success in Healthcare - Process Automation & Intelligent Workflows
What if we could develop a smart and efficient workflow that ensures payment accuracy from the start?
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Data Sheet: Source Professional Services
HealthEdge understands that containing costs is the biggest challenge payers face today. Implementing new technologies, processes, and other cost containment strategies takes time and resources
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