Avoid Payment Integrity Pitfalls with HealthEdge Source's Unified Platform

Health plans face significant challenges in ensuring accurate claim payments due to fragmented systems, multiple vendors, and complex workflows. These issues lead to inefficiencies, high administrative costs, and payment inaccuracies, with 3-7% of claims often paid incorrectly. Managing multiple systems for pricing, editing, and auditing creates additional burdens, including inconsistent updates, lack of transparency, and difficulty in deriving actionable insights from data. HealthEdge Source™ addresses these challenges by consolidating pricing, editing, and analytics into a single, cloud-based platform. It integrates all payment policies, CMS and Medicaid updates, and custom configurations, allowing health plans to manage claims efficiently and accurately. Key features include automated updates, flexible configurations, real-time analytics, and a transparent audit trail. By unifying these processes, HealthEdge Source reduces reliance on multiple vendors, lowers administrative costs, and empowers health plans to identify and resolve issues upstream, improving payment accuracy and operational efficiency. Check out our resources to learn more: https://learn.healthedge.com/healthedge-source-resources-for-your-health-plan