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

New and Exciting Member Content in Maternity, Menopause, Behavioral Health, and More

May 13, 2024

Download PDF

New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

New and Exciting Member Content in Maternity, Menopause, Behavioral Health, and More

Medicare Member Impact Report Wellframe

AI in Care Management Use Cases - Now and Next

2024 Healthcare Consumer Survey Results

Leveraging GuidingCare Technologies and Tools for the Hardest Clinical Populations and Use Cases (LTSS, D-SNP, Medicaid, Medicare, etc.)

Benefits and Opportunities of an Integrated Care Management Experience

A Historic Context for Measuring the Value of Technology Innovation in Care Management

Nationwide Top Ride-Along Recommendations

Welcome Remarks

2023 Case Studies: Secondary Editing

2023 Case Studies: Retroactive Change Manager

Leadership Forum 2023 Staying on Top of Regulations

Leadership Forum 2023 Navigating Change

IDC HealthEdge Leadership Forum Presentation

Leadership Forum 2023 Building the Bridge for Member Engagement

Healthfirst HealthEdge Presentation

Leadership Forum 2023 CEO Address

RJ Health Source Use Case

ROI of Source Add-On's

Retroactive Change Manager Overview

Retroactive Change Manager Case Study