Brochure: Plans With Home and Host Capabilities - How to Stay Ahead of the Curve
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Case Study: 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.
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eBook: 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
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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.
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Data Sheet: Configuration as a Service Expedites Time-to-Value for Health Plans
HealthEdge's Configuration as a Service optimizes HealthRules® Payer system configurations, accelerating time-to-value for health plans.
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Data Sheet: HealthEdge Source - Software for Health Plans With Home & Host Capabilities
HealthEdge Source™ is a cloud-based solution designed to enhance payment accuracy and integrity for health plans with home & host capabilities.
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Brochure: Value-Based Care - Health Plans With Home & Host Capabilities Are Market Leaders
In our work with HealthRules® Payer clients, we have gained first-hand experience, supporting these plans with the technology they need to lead value-based care and healthcare transformation.
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Data Sheet: HealthRules Payer for Plans with Home & Host Capabilities
Health plans with home and host capabilities have been leading the healthcare industry since 1929 and continue to hold strong with top industry rankings today.
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Data Sheet: Platform Access Delivers a Transformative Approach to Payment Integrity
The evolving complexities of healthcare claims places tremendous pressure on healthcare payers to manage their payment integrity programs more effectively.
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Data Sheet: Optimize Payment Accuracy with History-Based Editing
As more contracts and policies shift toward value-based care and billing requirements, evolve, the opportunities for inaccurate payments increase...
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Case Study: SummaCare - Value of Editing & Pricing in Source
The case study highlights the value of pricing & editing using Source, a comprehensive platform that has streamlined vendor solutions for Medicare Advantage employer groups and commercial claims.
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Video: SummaCare Case Study - What Makes Source Different
Since 2009, SummaCare has enjoyed a long-standing partnership with HealthEdge Source™. In this video, Vice President of Operations Melissa Rusk explains how no other vendor matches the convenience...
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Case Study Q&A Video: SummaCare & HealthEdge Source Partnership
SummaCare Health Plan, based in Akron, Ohio, is a provider-owned health plan with around 62,000 members.
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Data Sheet: HealthRules® Payer named “Best in KLAS” in 2023 Research Report
HealthRules Payer has been named “Best in KLAS” by KLAS Research for Claims & Administration Platforms for the second year in a row.
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Data Sheet: Point-of-Service Payment System Success - Integrated Ecosystems (PDF)
Traditional claims systems are often fragmented and inefficient, leading to significant errors and unnecessary operational costs.
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Data Sheet: Cloud-Based Data Delivery in Healthcare — Point-of-Service Payment Success Path
In today's healthcare landscape, the complexity and inefficiencies of payment systems are a common source of frustration for patients, providers, and payers alike.
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Data Sheet: Point-of-Service (POS) Payment Success in Healthcare - Process Automation & Intelligent Workflows
What if we could develop a smart and efficient workflow that ensures payment accuracy from the start?
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White Paper: Prospective Payment Integrity Moving from Pay and Chase to Predictive
This Spotlight examines payer payment integrity platforms and how payers can aggressively apply analytics and coordinate workflows to move "left" from reactive postpay to proactive, predictive prepay.
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Data Sheet: Source Professional Services
HealthEdge understands that containing costs is the biggest challenge payers face today. Implementing new technologies, processes, and other cost containment strategies takes time and resources
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Data Sheet: Automatically Manage Retroactive Policy and Pricing Changes
Healthcare policy changes demand that health plans actively manage retroactive components, often requiring internal teams and third-party vendors for claims recovery.
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