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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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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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3 Functional Areas That are Ripe for immediate Operational Efficiency Games

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Wellframe Care Program Overview 2024

Foundational Data Export 2024

Leadership Forum 2024 - Health IT Trends for Healthcare Payers

Leadership Forum 2024 - Harnessing Data to Drive Progress Insights for Transformative Change

Leadership Forum 2024 - Intro

Leadership Forum 2024 - Building Tomorrow’s Integrated Digital Platform Today

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Medicare Member Impact Report Wellframe

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2024 Healthcare Consumer Survey Results

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Nationwide Top Ride-Along Recommendations

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2023 Case Studies: Secondary Editing

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Leadership Forum 2023 Staying on Top of Regulations