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CONNECT TO
A COMPREHENSIVE DIGITAL TRANSFORMATION.A TRULY MEMBER-CENTRIC EXPERIENCE.MORE
AUTOMATED OPERATIONS.THE NEXT GENERATION OF SERVICE.A COMPREHENSIVE DIGITAL
TRANSFORMATION.A TRULY MEMBER-CENTRIC EXPERIENCE.MORE AUTOMATED OPERATIONS.THE
NEXT GENERATION OF SERVICE.A COMPREHENSIVE DIGITAL TRANSFORMATION.

HealthEdge® solutions – deployed as standalone next-generation SaaS or together
as an integrated platform – help payers accelerate their digital transformation
and position them for continuous success.

Make the connection

The Digital Payer Journey to Achieve a Coherent Individual Healthcare Experience

The individual healthcare experience has three dimensions. Each dimension
requires deep application focus and an integrated approach to applications and
data.

READ MORE

HealthRules® Payer named “Best in KLAS®”

HealthRules Payer has been named "Best in KLAS" by KLAS Research for Claims &
Administration Platforms for the second year in a row.

READ MORE

Voice of the Market: 2022 Digital Transformation Survey

HealthEdge Survey Highlights Growth Opportunities and Challenges for Health Plan
Leaders

READ MORE

The Digital Payer Journey to Achieve a Coherent Individual Healthcare Experience

The individual healthcare experience has three dimensions. Each dimension
requires deep application focus and an integrated approach to applications and
data.

READ MORE

HealthRules® Payer named “Best in KLAS®”

HealthRules Payer has been named "Best in KLAS" by KLAS Research for Claims &
Administration Platforms for the second year in a row.

READ MORE

Voice of the Market: 2022 Digital Transformation Survey

HealthEdge Survey Highlights Growth Opportunities and Challenges for Health Plan
Leaders

READ MORE

The Digital Payer Journey to Achieve a Coherent Individual Healthcare Experience

The individual healthcare experience has three dimensions. Each dimension
requires deep application focus and an integrated approach to applications and
data.

READ MORE
 * 1
 * 2
 * 3


HEALTHEDGE BY THE
NUMBERS


76+

MILLION COVERED LIVES SERVED BY 4 SOLUTIONS

See Our Solutions



120+

CUSTOMERS

See Our Solutions



100+

INTEGRATIONS WITH THIRD-PARTY SOLUTIONS

See Our Solutions



48+

STATES SUPPORTED WITH 23 MEDICARE ADVANTAGE CLIENTS

See Our Solutions



WHAT CAN HEALTHEDGE
DO FOR YOU?

Our healthcare SaaS software provides payers with a digital foundation that
enables them to deliver a transparent and consumer-centric experience at lower
cost while offering higher quality and higher service levels to their members,
providers and partners.

see our solutions

X


A TRULY CONNECTED
ECOSYSTEM

Whether connecting to our best-of-breed applications or other third-party
systems, HealthEdge enables health plans to access data within and between
systems for new digital member experiences. HealthEdge is on a digital journey
with our customers to make it easy to exchange real-time data and streamline
workflows across once-siloed functional areas and data.

See Our Solutions

HEALTHEDGE

Digital Transformation in Healthcare

HEALTHRULES PAYER

Core
Administration

SOURCE

Prospective
Payment Integrity

WELLFRAME

Member
Experience

GUIDINGCARE

Care
Management



ENABLING THE DIGITAL
PAYER

What does it mean to be a digital payer in today's highly complex and dynamic
health insurance market? It means every aspect of your business is constantly
improving. While working with hundreds of payers, we consistently see the
following five attributes in our digital-first customers:

Become a Digital Payer

EVER-EVOLVING FOCUS ON THE MEMBER AND END-USER EXPERIENCE

Modern technology and seamless exchange of real-time data facilitate a better
experience

EVER-DECLINING TRANSACTION COSTS

Automating business processes based on accurate data drives down costs and
drives up productivity

EVER-IMPROVING QUALITY

Accessing accurate insights from real-time data across lines of business and
care provider networks results in better health outcomes

EVER-INCREASING SERVICE LEVELS

Empowering team members with modern technology and up-to-the-minute data results
in better service

EVER-IMPROVING BUSINESS TRANSPARENCY

Greater visibility and robust analytical tools lead to more informed business
decisions


FURTHER RESOURCES


 * PROSPECTIVE PAYMENT INTEGRITY MOVING FROM PAY AND CHASE TO PREDICTIVE
   
   This Spotlight examines payer payment integrity platforms and how payers can
   aggressively apply analytics and coordinate workflows to move "left" from
   reactive postpay to proactive, predictive prepay.
   
   Read More


 * HEALTHRULES® PAYER NAMED “BEST IN KLAS®”
   
   Read More


 * HEALTHEDGE COMPANY BROCHURE
   
   Read More


 * ANNUAL MARKET SURVEY REPORT 2022
   
   Read More


READY FOR YOUR DIGITAL TRANSFORMATION?

Meet with a transformational expert today to talk about how we can help you
solve today’s challenges while setting you up for future success.

SCHEDULE A CONSULTATION
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©2022 HealthEdge Software, Inc. | HealthEdge®, HealthRules®, The HealthRules
Language™, GuidingCare®, and the Wellframe logo are registered trademarks of
HealthEdge Software, Inc. All Rights Reserved.