About Anoteros
Anoteros is a boutique IT consultancy primarily focused on servicing the healthcare industry. We work with payers and providers on various types of IT initiatives, including IT strategy assessments, vendor selections, data initiatives and system implementations. In the care management space, we have worked with over 15 clients on GuidingCare projects. These projects include new installations, version upgrades, configuring new lines of business, letters development, and configuration support & maintenance. Our team of project managers, business analysts, integration specialists and clinical subject matter experts bring years of industry and technical experience in pursuit of helping our clients maximize their investment in GuidingCare.
About AXIOM
AXIOM Systems is an information technology solutions firm delivering an array of products and services exclusively to the healthcare industry.
AXIOM’s solutions are driven by its extensive knowledge of healthcare and a detailed understanding of the regulatory and technology issues that drive initiatives. Their products have been developed with one simple goal in mind, Simplifying HIPAA eCommerce.
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About CitiusTech
CitiusTech is one of the largest healthcare technology companies worldwide which provides digital innovation & technology modernization services to 140+ organizations.
We team up with payers, providers, life sciences & medical technology companies to accelerate their digital transformation roadmap. We work with several national, regional, Blues and specialty health plans to assist with cloud enablement, system implementation/integration, bespoke development, automation, testing, data & analytics etc. especially in the areas of member experience, value-based care, regulatory compliance and IT modernization.
CitiusTech has a close partnership with HealthEdge; we offer customers HealthRules configuration, data migration, technical services, testing, post implementation optimization services and surround health plan IT ecosystem strategy, road mapping and execution services in concert and in alignment with client’s HealthRules implementation. CitiusTech also assists HealthEdge with new feature development & client-specific customizations for its core platforms.
About FluidEdge
FluidEdge is a fully owned subsidiary of CitiusTech and provides strategic consulting services to healthcare organizations. FluidEdge brings senior leaders with decades of experience in health plan operations, process innovation and technology domains to help clients with their business transformation journey.
FluidEdge works closely with HealthEdge to provide clients with HealthRules implementation planning, current-state assessment, program management, operational transformation, training and data/process remediation services.
About eMids
Founded in 1999 and based in Nashville, Emids provides global digital transformation solutions across the healthcare ecosystem, providing tailored, cutting-edge solutions and services in the domaivns of engineering, design, and system management for payers, providers, biopharma, medical technology and healthcare technology firms. Emids’ core values as trusted guides and inclusive innovators obsessed with delivering impact and value for its customers are the cornerstones of its singular mission of advancing the future of health through impactful technology solutions.
Since 2007, Emids has been actively working with HealthEdge and their HealthRules platform. Our consultants have played a pivotal role in designing new features for HealthRules and have pioneered the development of HealthEdge’s inaugural partner training program. With expertise in both business and technical domains, Emids consultants have been instrumental in more than 40 implementations of the HealthRules platform.
About FindHelp
FindHelp (formerly Aunt Bertha) is a leading social services search-and-referral platform that enables payers to seamlessly connect their members with the social services they need the moment that need is recognized and the opportunity to positively impact that need is at its highest.
Through the GuidingCare integration with findhelp, care managers are provided instant access to comprehensive, localized listings with hundreds of programs in every ZIP code in the United States. The seamless integration provides a more efficient, effective process to make and manage referrals for critical services when members are in need.
Healthwise
Healthwise, a leader in evidence-based health education, is a 501-C3 nonprofit organization that empowers people to live their healthiest lives. More than 2 billion times, people have turned to Healthwise information to help navigate their unique health journeys with confidence. Leading hospitals, EMR providers, health plans, care management companies, health websites, and technology innovators partner with Healthwise to provide the world’s best health information—and achieve better health outcomes. We’ve championed our mission to help people make better health decisions since 1975.
GuidingCare and Healthwise have partnered to create workflows that enable care managers to seamlessly access and deploy personalized health coaching and education resources directly to members from the GuidingCare interface. The two-way integration also captures Healthwise fulfillment data in GuidingCare, so care managers can monitor member participation from their GuidingCare dashboards and make more informed care decisions.
MCG Health
MCG Health’s Cite CareWebQI provides wellrespected evidence-based guidelines to support clinical decision making. CareWebQI is integrated into GuidingCare’s Utilization Management module and Auth Portal for easy guideline access, improved clinical decision support, and streamlined care workflows. With CareWebQI’s integrated guidelines, GuidingCare customers can more effectively identify gaps in care and inform care strategies to improve patient outcomes. This partnership reduces unnecessary medical care that creates huge costs for health plans.
About NTT Data
NTT DATA is a $30 billion trusted global innovator of IT and business services. With our consultative approach, deep industry expertise and leading-edge technologies, we help clients accelerate their digital journey. We build long-term relationships based on shared success and trust, guided by our core values — clients first, foresight and teamwork. More than 50% of our clients have partnered with us for more than 10 years, and we currently serve more than 70 health plans, including 6 of the largest U.S. health insurers.
As a HealthEdge Strategic Partner, NTT DATA collaborates with health plans to achieve results: better operating margins, improved key performance indicators, net promoter member experiences, slower medical cost growth and regulatory compliance. Let’s discuss how our health plan capabilities — including BPaaS, BPO, application services, data analytics, provider data exchange, cloud and security services — combine with the full suite of HealthEdge solutions to bring your strategic vision to life.
About Optum
Optum (Change Healthcare is now a part of Optum) partners with HealthEdge to create more value for payers. Combining Optum solutions such as InterQual® (an evidence-based clinical decision support solution), Communications and Payment Services, HealthRules Connectivity Services, and Settlement Advocate (Provider Payments) with the HealthEdge HealthRules platform delivers significant value to health plans.
Some of those benefits include increased auto adjudication rates, increased provider satisfaction, increased member engagement, all the benefits attached to going digital, increased savings, and increased performance.
Together, Optum and HealthEdge deliver greater value end-to-end for all stakeholders in the healthcare ecosystem.
About Persistent
For the past 30+ years, Persistent has been a trusted engineering partner for 125+ healthcare & life sciences clients. We combine deep domain and technology expertise to provide digital strategy & design, software product engineering, application development & management, customer experience transformation, cloud, infrastructure & security, intelligent automation, data & AI, and enterprise integration services.
Our partnership with HealthEdge encompasses end-to-end services around HealthRules and GuidingCare products. The services include strategy & consulting, gap analysis, roadmap, configuration, implementation and customizations, support & enhancements, and new feature development. Our vision is to bring best in class services to improve speed to market, enhance productivity, and optimize costs.
About PulseData
PulseData delivers data-driven, clinically validated, predictive insights at the point of care. Leveraging large, diverse datasets and extensive clinical expertise, PulseData’s cutting-edge machine learning and AI models produce earlier risk identification and person-specific care recommendations, reinforcing healthcare team care management and person-engagement efforts.
PulseData’s actionable insights are seamlessly integrated into your GuidingCare clinical workflows, reinforcing care management resources, and simplifying the providers’ ability to act. PulseData’s strategic integration of technology and healthcare empowers care providers to make well-informed decisions, helping improve patient outcomes, reduce costs, and improve the person’s overall care delivery experience.
About SmartComm
Smart Communications provides the pure-cloud platform that many of the world’s largest health organizations trust to increase operational efficiency and deliver highly secure, frictionless experiences across the customer lifecycle and on all touchpoints and channels. The Conversation Cloud™ consists of SmartCOMM™ for managing customer communications and SmartIQ™ for simplifying and automating forms and other data-intensive processes. By integrating SmartCOMM with HealthEdge Guiding Care and HealthRules, we help create deeply personalized and compliant real-time member engagement. Visit smartcommunications.com to learn more about the platform that leading analyst firms rank as an industry leader.
Unite Us
Unite Us offers health plans access to one of the nation’s largest coordinated care networks of health and social service providers who are connected through Unite Us’ shared technology platform. When integrated with GuidingCare, the solution establishes a new standard of care that identifies social care needs in communities, connects individuals to services, and leverages meaningful outcome data to further drive community investment. With a more holistic view of members’ social and medical health, health plans can positively impact member outcomes while also improving their organization’s quality measures.
About UST HealthProof
UST HealthProof delivers a fully integrated, modern technology ecosystem for health plans that is tested and proven around the most advanced core administrative system in the industry – HealthEdge’s HealthRules. HealthProof unique approach reduces administrative burden and costs for core administration and clinical operations, reducing administrative costs by 25 – 30% and allowing plans to focus on outcomes, delivering health care for less and growth.
UST HealthProof has over 50 health plans and administers and services over 6.3 million members who benefit from UST HealthProof’s expertise.
About WellSky
WellSky Social Services platform (formerly Healthify) works with payers and providers to integrate SDOH into the healthcare ecosystem. The GuidingCare platform integrates with WellSky’s infrastructure to help health plans more effectively address SDOH – nonclinical factors such as poverty, housing instability and food insecurity – that impact health outcomes. Integrating WellSky’s technology into GuidingCare enables care managers to identify, refer, confirm delivery, and track outcomes for the social services needs of their members while on the GuidingCare platform.
About Zelis
Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients. Learn more at Zelis.com and follow us on LinkedIn to get the latest news.