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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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Report: Digital Care Management can help lower blood sugar by more than 25%

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New from HealthEdge

3 Functional Areas That are Ripe for immediate Operational Efficiency Games

Report: Digital Care Management can help lower blood sugar by more than 25%

Case Study: Modernizing with HealthEdge® to Drive Expansion

Case Study: Modernizing Care Management and Operations with HealthEdge® Solutions

Case Study: Health Plan for Large Metropolitan Area Transforms Care and Operations with HealthEdge® Solutions

Case Study: Empowering Innovative Healthcare with Integrated HealthEdge® Solution

Case Study: Digital Health Improves Care Transitions For Members With Multimorbidities

Demonstrating the value of digital health with a new methodology

A large Blues plan uses Wellframe Digital Health Management to Drive Care Management Capacity and Member Engagement

Report: Digital Care Management can help lower blood pressure by more than 9%

Case Study: Improving Maternal Health Outcomes Through Digital Engagement

HealthRules Payer Case Study with Presbyterian

Case Study: VillageCare

Case Study: Managing Payment Complexity to Improve Operational Efficiency

Case Study: Regional Non-Profit - Leveraging Source for Efficient Claims Audit & Inquiry

Case Study: Denver Health Medical Plan Customer Spotlight

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

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

Case Study: Non Profit Midwestern Health Plan

Case Study: Easing Healthcare Preauthorizations - Priority Health

Case Study: AmeriHealth Administrators

Case Study: Large Southeast Payer