Regulatory & Compliance

HealthRules Payer Case Study with Presbyterian

HealthEdge had the opportunity to sit down with Presbyterian Health Plan leadership to learn more about why their organization decided to make the switch to HealthRules Payer as it's CAPS partner.

Infographic: A Member Journey After the No Surprises Act

The implementation of the No Surprises Act (NSA) has significantly transformed the healthcare landscape, particularly in how health plans manage regulatory mandates and ensure member satisfaction.

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

Data Sheet: Source Medicaid Michigan

Source deliveries in-depth MI Medicaid content that includes state-specific fee schedules and payment policies across a wide range of facility and professional provider types.

Data Sheet: HealthRules Payer - Resiliency to Change

Health plans must quickly and effectively react to the latest regulatory shifts, competitive pressures, opportunities for expansion, large-scale public health...