The HealthEdge Source Solution Suite

Professional Services

We understand that containing costs is the biggest challenge payers face today. Implementing new technologies, processes and other cost-containment strategies takes time and resources – something most payers do not have enough of.

That’s where HealthEdge Source™ Professional Services can help. Our HealthEdge Source experts are stewards of our solution, with a mission to equip your internal teams with the knowledge and support to strategize, operationalize and realize cost containment measures that impact your bottom line.

Professional services

"The team at Source was just awesome. They have some incredibly knowledgeable people." - VP of Operations, Mid-Sized Regional Health Plan

46% of Healthcare Executives consider managing costs a top organizational challenge. Source Professional Services was designed to help strategize, operationalize and realize cost containment measures.

"Their [Source] team is very patient with questions and always willing to get on a call." - VP of Operations, Mid-Sized Regional Health Plan


Contract confidence
Contract Configuration

Our subject matter experts partner with your team to configure contracts within HealthEdge Source, including configuration of default rates, custom carve-outs, fee schedules and other complex terms.

Contract maintenance
Contract Maintenance

Evaluate existing contract configurations used by your team and identify areas for optimization to reduce maintenance and improve workflow.

Enterprise Benchmarking

Reprice every production claim at any frequency in a post-return analytics queue and create a 100% Medicare baseline result grouped by dozens of categories in multi-dimensional reports.

Data studies
Data Studies

Gain insight into your business and make informed business decisions based on actual modeling scenarios. Customized for existing clients and prospective clients.

Product education
Product Education

Go beyond standard implementation training and gain a deeper understanding of specific product components, including configuration design, edit creation, training on new features and more.

Content education
Content Education

Learn more about all aspects of policy and payment methodologies, including provider type methodologies, policy-specific aspects, and CMS updates and revisions.

Agile services
Agile Services

A unique service offering to accommodate your business needs. Focus may include combining multiple Professional Services offerings, exploration of workflow challenges, specialized enhancements, integration and data mapping, and more.

Editing builder
Edit Creation

Optimize your edits with our team of experts for the design and development of net new edits in Source.

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Gain the power to perform enterprise-wide decision support for setting medical policy, contract renegotiations, and analyzing billing and utilization trends.


Why We’re Different

Experience in Design and Automation

Inefficient design and manual processes typically result in an additional $5-$10 per claim. Our Professional Services team provides years of experience maximizing pricing and editing automation with a high degree of provider contract terms accuracy to drive down costs.

Improved Effectiveness

While internal or other third parties requiring multiple FTEs can drive up costs, our fully trained and scalable workforce has the ability to flex to our client’s needs.

Increased Time to Value (TTV)

Our dedication to achieving rollout deadlines requires no ramp-up period to train internal resources or other third parties and enables us to meet rolling go-live dates.

Efficient Maintenance Plan

Our maintenance plan promotes smart sharing of similar contract terms to help streamline changes and promote accuracy – removing the need for health plans to rely on internal FTE resources.

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Payer-Source Integration

The integration between HealthRules® Payer and HealthEdge Source creates a new level of operational efficiency and accuracy in claims pricing and editing. With the continuous management of payment integrity and core administrative processes between platforms, the Payer-Source integration enables:

  • A single source of truth
  • Increased accuracy
  • Organization-wide IT lift
  • Improved payment integrity
  • Streamlined support model

The increased transparency gained from the Payer-Source integration improves payer-provider relations and member satisfaction.

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The HealthEdge Source Solution Suite

HealthEdge Source Medicare Reimbursement

Delivers, manages and maintains CMS pricing data for comprehensive payment accuracy.

HealthEdge Source Medicaid Reimbursement

Pay Medicaid claims accurately, quickly and comprehensively – the first time.

HealthEdge Source Commercial Reimbursement

A dynamic solution that simplifies contract configuration and provides accurate modeling.

HealthEdge Source Editing

Comprehensive support to handle complex policies automatically across all lines of business.

HealthEdge Source Platform Access

Enabling payers to gain control of their IT ecosystem through radical transparency.

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Additional Offerings

HealthEdge Source Analytics

Our Business Intelligence capabilities enable enterprise-wide decision support for setting medical policy, renegotiating provider contracts, and identifying and remediating billing and utilization trends within your provider network.

HealthEdge Source Professional Services

Our HealthEdge Source experts are stewards of our solution, with a mission to equip your internal teams with the knowledge and support required to optimize your business.

HealthEdge Source Third-Party Integrations

Incorporate third-party solutions and their data into a cohesive workflow for true interoperability of normally disjointed solutions.