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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

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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

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Source is the preeminent digital prospective payment integrity solution, combining claim payment automation with proactive business intelligence.
Source Solution Suite

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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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3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Data Sheet: Member Travel Card & HealthRules Payer

Data Sheet: HealthRules® Payer Named “Best in KLAS®” Three Years in a Row

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

Infographic: EDGEcelerate

Infographic: A Member Journey After the No Surprises Act

Data Sheet: Navigating the No Surprises Act - The Right Tools for Health Plan Success

Video: Care-Payer

Data Sheet: Achieving Transparency Compliance Through HealthRules Payer

Data Sheet: Configuration as a Service Expedites Time-to-Value for Health Plans

Brochure: Value-Based Care - Health Plans With Home & Host Capabilities Are Market Leaders

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

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

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

Data Sheet: SmartComm for HealthRules Payer

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

Data Sheet: HealthRules Payer + Source Integration

Data Sheet: HealthRules Promote

Data Sheet: HealthRules Payer Best in KLAS Report

Data Sheet: HealthRules Payer Platform Overview

Data Sheet: HealthRules Answers

Gartner Reports Next-Gen CAPS Technology Will Be Standard By 2024