The HealthRules Solution Suite
HealthRules®
Answers
Real-Time Business Intelligence Solution
HealthRules Answers provides the insights you need to better understand your business and drive operational efficiency – helping you reduce costs, identify market opportunities, validate new product offerings and support next-generation business models.
Easy to deploy and infinitely scalable, HealthRules Answers enables you to analyze key drivers of business performance, understand the impact of important market changes, and answer “what-if” questions to drive greater innovation, efficiency and agility.
And your organization isn’t the only beneficiary. HealthRules Answers also provides actionable business information to your members, providers and partners – giving everyone the real-time insights it takes to be successful and grow.
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Gartner has named HealthEdge® as a Sample Vendor for HealthRules Payer in the 2022 Hype Cycle for 12 consecutive years
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KLAS Research named HealthRules® Payer its 2023 “Best in KLAS” payer claims and administration platform
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Features
Real-Time Data Warehouse
The data warehouse offers a real-time repository of claims, financial, membership and provider data that payers can analyze to monitor any operational parameter. English-like HealthRules LanguageTM statements allow greater insight into the relationships between benefit plans and provider contracts and their financial outcomes.
Reporting
A straightforward custom reporting tool designed for reporting team members to develop comprehensive libraries of internal and external reports, graphs, dashboards, etc. Extensive control over data selection, rich visualizations, drill-down, scheduling and email capabilities.
Dashboards
The HealthRules Answers dashboard includes interactive charts that work together to display key operational data associated with core functions, such as claims, utilization management, membership, and revenue management. Users can explore multiple views to highlight the most relevant aspects.
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Why We’re Different
Data Warehouse
A comprehensive data warehouse that provides flexibility and agility not possible with other solutions
Real-Time Updates
Critical updates on key business performance measures via operational reports and dashboards
Capabilities to spot trends, correlations and root causes within key data
“What-If” Modeling
Answers to “what-if” questions that can be used to make key business decisions
The ability to identify new market opportunities and validate new products
The HealthRules Solution Suite
HealthRules Payer
HealthRules Payer provides transformational capabilities to health plans of all types and sizes with features that align with your business processes and functional areas.
EXPLORE PRODUCTHealthRules Answers
Our HealthRules Answers business intelligence solution transforms the way you see and use data in real time, helping to reduce costs, identify market opportunities, validate new product offerings, and support next-generation business models.
Learn MoreHealthRules Connector
HealthRules Connector is a robust integration layer that links HealthRules seamlessly with other systems, partner networks, and exchanges so you can share critical healthcare information quickly, easily and securely.
EXPLORE PRODUCTAdditional Offerings
HealthRules Promote
Our Configuration and Promotion application enables your organization to benefit from increased automation, greater accuracy, a simplified process and lower costs.
EXPLORE PRODUCTHealthRules Home and Host Processing
HealthRules Payer offers built-in capabilities to support all aspects of the home and host program, reducing complexity and eliminating unnecessary duplication of provider data.
EXPLORE PRODUCT