Video: Care-Payer

HealthEdge's HealthRules^® Payer and GuidingCare Solutions are industry-leading standalone products in core claims administration and care management, respectively. These solutions offer exceptional value individually, but their combined capabilities through Care-Payer distinguish them in today's market. Care-Payer facilitates seamless data exchange between HealthRules Payer and GuidingCare, enabling continuous management of member care and core administrative processes via a modern, API-based integration.

Key features of Care-Payer include:

• Standardized Core Data Delivery from HealthRules Payer to GuidingCare.
• Enhanced Authorization Entry Workflows, including Single Case Agreement and Referral Category improvements.
• Near Real-Time Authorization Delivery from GuidingCare to HealthRules Payer.
• Unique Benefit Predictor Integration enabling GuidingCare users to address complex benefit questions in real-time.

HealthEdge is the only company offering the Benefit Predictor, providing unparalleled access to real-time benefit information integrated into key workflows. Utilizing Care Payer, HealthEdge customers can expect benefits such as smooth implementations, synchronized data sets, improved operational efficiency, enhanced payment integrity, and certified data exchange.