Plans with Home and Host

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

Experts in managing complex CMS data for over 25 years. Partnering with top payers for 10+ years.

eBooks: 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

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.

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

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.

Data Sheet: HealthEdge Source - Software for Health Plans With Home & Host Capabilities

HealthEdge Source™ is a cloud-based solution designed to enhance payment accuracy and integrity for health plans with home & host capabilities.

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.

Data Sheet: Platform Access Delivers a Transformative Approach to Payment Integrity

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...

Data Sheet: HealthRules® Payer named “Best in KLAS” in 2023 Research Report (PDF)

HealthRules Payer has been named “Best in KLAS” by KLAS Research for Claims & Administration Platforms for the second year in a row.

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.

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.

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?

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

Data Sheet: Automatically Manage Retroactive Policy and Pricing Changes

Healthcare policy changes demand that health plans actively manage retroactive components, often requiring internal teams and third-party vendors for claims recovery.

eBooks: Challenging Reimbursement in Healthcare Claims Payments With Source

When it comes to handling reimbursement, dealing with incorrect payments caused by inaccessible pricing data and disjointed payment solutions can be a significant issue.