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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

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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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Webinar: Empowering Modern Health Care Consumers Insights from the 2024 Survey

May 31, 2024

New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Webinar: Empowering Modern Health Care Consumers Insights from the 2024 Survey

2024 HealthEdge Consumer Survey Key Trends

2024 Healthcare Consumer Survey: Key Trends and Expectations

2024 HealthEdge Annual Payer Market Report

Modernizing Healthcare Payers: Insights from the HealthEdge® Annual Payer Market Report

Infographic: 2024 HealthEdge Annual Payer Market Survey

Top 5 Challenges Facing Health Plan Leaders in 2024

Empowering Health Plans to Satisfy Members: Insights from the 2023 HealthEdge Consumer Survey

Annual Market Survey Report 2022

Consumer Survey Satisfaction Insights Report 2023

Consumer Survey Satisfaction Insights Report 2019

Executive Summary: 2022 Annual Market Survey

Key Insights from Nationwide Survey: Understanding Your Medicaid and Dual-Eligible Members as Consumers

55% of Healthcare Consumers are not Fully Satisfied with their Health Insurance