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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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Data Sheet: What Is a Chronic Illness & Disability Payment System+Rx (CDPS)

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New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Data Sheet: What Is a Chronic Illness & Disability Payment System+Rx (CDPS)

The Future of Care Management Platform Training — GuidingCare® University

Case Study: VillageCare

Infographic: Health Plan Member Satisfaction - The Current State

Infographic: Secrets of a Successful Care Management Implementation

Case Study: Denver Health Medical Plan Customer Spotlight

AHIP Webinar: Satisfying Your Members as Consumers: What Matters Most Today

Consumer Survey Satisfaction Insights Report 2023

Top Areas of Focus for 2023 Regulations and Beyond: Interoperability and Transparency

Interoperability Strategies for Successful Care Management

Infographic: EDGEcelerate

Data Sheet: GuidingCare Mobile Clinician

Video: Interoperability Must Haves - Part 1

Video: Interoperability Must Haves - Part 2

Video: Interoperability Must Haves - Part 3

Data Sheet: GuidingCare Utilization Management & Appeals and Grievances

Data Sheet: GuidingCare® Business Rules Designer

Infographic: GuidingCare Clinical Expertise

Executive Summary: Effective Care Management for a Complex Market

eBooks: A Digital Transformation Journey

Value Based Care Software to Improve Healthcare Outcomes