Solutions
Solutions Solutions

Core Administrative Processing System

The HealthRules® Solutions Suite includes the industry’s leading digital claims administration processing system – plus a host of additional value-added capabilities.
Healthrules Solution Suite

Care Management Workflow Solutions

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

Prospective Payment Integrity

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

Member Experience

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

Professional Services Customer Success Care-Payer Integration Payer-Source Integration Partners
Lines of Business
Commercial

Government

Medicaid Medicare Dual-Eligibles

Plans With Home & Host Capabilities

Dental

Consultants
Resources
Blog

Core Admin

Care Management

Payment Integrity

Member Engagement

Professional Services

Case Studies

Regulatory & Compliance

Advanced Automation

New Market Expansion

Value-Based Care

Events

Newsroom

Company News

Press Releases

Help Center

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

READ BLOG POST
About Us
Leadership

Careers

Life at HealthEdge US Office India Office Employee Testimonials

Job Openings

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

Download PDF

New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

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

HealthRules Payer Case Study with Presbyterian

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

eBooks: CMS Transparency in Coverage Rule

Data Sheet: Navigating the No Surprises Act - The Right Tools for Health Plan Success

Data Sheet: Achieving Transparency Compliance Through HealthRules Payer

Source Platform Access Delivers a Transformative Approach to Payment Integrity

Data Sheet: Configuration as a Service Expedites Time-to-Value for Health Plans

Brochure: Value-Based Care - Health Plans With Home & Host Capabilities Are Market Leaders

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

Data Sheet: Optimize Payment Accuracy with History-Based Editing

Case Study: SummaCare - Value of editing & pricing in Source

Case Study Q&A Video: SummaCare & HealthEdge Source Partnership

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

Data Sheet: Point-of-Service Payment System Success - Integrated Ecosystems (PDF)

Cloud-Based Data Delivery in Healthcare: Point-of-Service Payment Success Path

Data Sheet: Point-of-Service (POS) Payment Success in Healthcare - Process Automation & Intelligent Workflows

Data Sheet: Source Professional Services

Data Sheet: Automatically Manage Retroactive Policy and Pricing Changes

eBooks: Challenging Reimbursement in Healthcare Claims Payments With Source

Data Sheet: Source Editing