ACA Exchange

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.

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.

Data Sheet: HealthEdge Source: Software for Health Plans With Home & Host Capabilities

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.

Data Sheet: Platform Access Delivers a Transformative Approach to Payment Integrity

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...

Data Sheet: HealthRules® Payer named “Best in KLAS” in 2023 Research Report (PDF)

HealthRules Payer has been named “Best in KLAS” by KLAS Research for Claims & Administration Platforms for the second year in a row.

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.

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.

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?

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.

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.

Brochure: Prospective Payment Integrity

Data Sheet: Cloud-Based Pricing and Editing Content for Effortless Upgrades

Source offers a comprehensive full-service model designed to streamline and automate the process of software updates, ensuring clients stay ahead in compliance and operational efficiency.

Case Study: Large, National Health Insurer

A leading national health insurer, already ranked among the top 15 insurance companies with over 6 million members, set out on an ambitious growth plan.