HealthRules Payer

Data Sheet: Integrated Secondary Editing Solution Now Available to HealthRules® Payer Clients

Advanced secondary editing from HealthEdge Source™ helps reduce inappropriate claims before they are paid.

Infographic: EDGEcelerate

Infographic: A Member Journey After the No Surprises Act

The implementation of the No Surprises Act (NSA) has significantly transformed the healthcare landscape, particularly in how health plans manage regulatory mandates and ensure member satisfaction.

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: Achieving Transparency Compliance Through HealthRules Payer

Achieving regulatory compliance in the healthcare industry is a complex and evolving challenge, particularly with mandates such as the Transparency in Coverage (TIC) Final Rule and the No Surprises Ac

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.

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: Member Travel Card & HealthRules Payer

Data Sheet: HealthRules Payer for Plans with Home & Host Capabilities

Case Study: HealthRules® Promote Empowers Medica Health Plan to Streamline Processes

Large non-profit health insurance provider helps create a more efficient way to manage complex configurations and multiple instances of HealthRules Payer.

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: SmartComm for HealthRules Payer

Case Study: Elderplan uses HealthRules® Payer to Lower Administrative Costs

Today’s health plans have less money to reinvest in critical areas such as innovation, member satisfaction, care coordination, and new lines of business.

Data Sheet: HealthRules Payer + Source Integration

Data Sheet: HealthRules Promote

HealthRules Promote empowers business analysts to focus on HealthRules configuration goals and confidently deploy changes into production with ease.

Data Sheet: HealthRules Payer Best in KLAS Report

Data Sheet: HealthRules Payer Platform Overview

HealthRules Payer helps health plans quickly address market opportunities, provide customer and provider satisfaction, and lower administrative costs through automation.

Data Sheet: HealthRules Answers

HealthRules® Answers is a cutting-edge web-based business intelligence solution tailored to meet the needs of today's healthcare organizations.