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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.
Healthrules Solution Suite

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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

Prospective Payment Integrity

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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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

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3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Release Notes

Improvements in Customer Experience for Q3 2024

One HealthEdge Executive Release Notes Q3 2024

HRP Executive Release Notes - Q2 2024

One HealthEdge Executive Release Notes Q2 2024

HealthEdge® Solutions Continue to Deliver New Innovation & Product Enhancements Q1 2024

HealthRules Payer Release Notes - Executive Summary

HealthEdge Solutions Continue to Expand Capabilities and End User Productivity

HealthEdge Solutions Continue to Expand Capabilities and Usability

Latest Innovations for Your HealthEdge Solutions: What’s New in 2023?