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

April 26, 2023

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

How Health Plans Can Use Advanced Analytics to Address Common Challenges

GuidingCare University: Advancing Product Knowledge for Existing Users

Top 5 Payment Integrity Trends Health Plans Should Respond To For 2025

Paper: Compliance with Prior Authorization Mandates Is a Strategic Opportunity for Payers

Data Sheet: HealthEdge Source™ - Medi-Cal Reimbursement

GuidingCare® University: Streamlined Onboarding and Training for New Staff

Webinar: Proactively Addressing Regulatory Complexities in California and Beyond

HealthRules Payer Case Study with Presbyterian

Infographic: A Member Journey After the No Surprises Act

eBooks: CMS Transparency in Coverage Rule

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

Video: Source Medicare Reimbursement

Video: Source Editing

Data Sheet: Achieving Transparency Compliance Through HealthRules Payer

Corporate Compliance & Security Compliance at HealthEdge

Interoperability Strategies for Successful Care Management

Data Sheet: Source Medicaid Michigan

Data Sheet: HealthRules Payer - Resiliency to Change

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

Case Study: Summacare - What does being a digital health plan mean to you?