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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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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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Case Study: Modernizing with HealthEdge® to Drive Expansion

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New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Case Study: Modernizing with HealthEdge® to Drive Expansion

HealthEdge Annual Payer Market Planning Report 2025

HealthEdge CEO, Steve Krupa, Vision Overview - Leadership Forum 2024

2024 HealthEdge Consumer Survey Key Trends

HealthEdge CTO, Rob Duffy, Vision Overview - Leadership Forum 2024

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Demonstrating the value of digital health with a new methodology

Driving Care Management Capacity and Engagement with Wellframe Digital Health

Report: Digital Care Management can help lower blood pressure by more than 9%

Report: Digital Care Management can help lower blood sugar by more than 25%

HealthEdge’s Provider Data Management

Infographic: 2024 HealthEdge Annual Payer Market Survey

Data Sheet: HealthRules® Payer Named “Best in KLAS®” Three Years in a Row

Infographic: The History of HealthEdge Source™ The Payment Accountability® Platform

2024 HealthEdge Annual Payer Market Report

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Data Sheet: Integrated Secondary Editing Solution Now Available to HealthRules® Payer Clients

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