Neighborhood Health Plan of Rhode Island Selects HealthEdge’s Award-Winning Software Suite to Address Next-Generation Healthcare Business Needs
Nationally recognized Medicaid health plan to use HealthRules Payor and HealthRules Answers to achieve a new level of productivity and customer service
Burlington, MA, October 14, 2009—HealthEdge, provider of the only modern, enterprise-class software platform for healthcare payors, announced today that Neighborhood Health Plan of Rhode Island (Neighborhood) has selected HealthRules Payor and HealthRules Answers after a comprehensive vetting process involving six leading vendors. Neighborhood, an award-winning Medicaid health plan serving more than 78,000 members, will use the HealthRules products to enhance claim and benefit administration, reduce administrative costs, improve transparency, and increase operational efficiencies.
"Only HealthEdge offers the features, flexibility, functionality and can-do culture needed to ensure that we can provide our members the highest level of customer service while maximizing our productivity," said Nancy Coburn, chief operating officer at Neighborhood. "HealthEdge's proven, patented, language-based technology will enable us to quickly and easily implement innovative plan designs, address new healthcare regulations and standards, and respond, in real-time, to member and provider needs. This will allow us to focus our resources on continuing to improve access to healthcare for Rhode Island residents."
Coburn referenced the impending requirements to migrate to the ICD-10 and EDI 5010 standards to illustrate her point. "These mandated changes, which have the potential to cause mass disruption across the industry, are already included in the HealthRules product suite. This means that we can look forward to an automated, seamless transition," she explained. "Equally important, implementing these HealthEdge solutions will improve our ability to respond to our member's needs and will minimize our costly and time-consuming manual claim processing."
The HealthRules Payor and Answers products will also substantially streamline Neighborhood's reporting methods, which currently require employees to use a range of manual processes to retrieve and analyze information from up to six disparate information systems. These reports, along with their capabilities related to utilization review, case management, and disease management, are used to drive Neighborhood's aggressive outreach initiatives, allowing them to improve member health by continuously identifying and encouraging preventive screenings and recommending appropriate follow-up care.
"Not only had we outgrown the capabilities of our current system, but our previous vendors have stopped supporting their products," Coburn explained. "Replacing them with HealthEdge is a true win/win. Our staff will be able to focus more time on improving quality and outcomes, instead of working on clerical and administrative tasks, and we will be better able to serve physicians and hospitals by improving reimbursement turnaround, enhancing communication, and increasing provider satisfaction."
"It is an honor to be chosen by Neighborhood, which has earned recognition as one of the country's top Medicaid plans" said Rob Gillette, CEO of HealthEdge. "We look forward to helping them further enhance their well-deserved reputation for innovation and excellence."
About Neighborhood Health Plan of Rhode Island
Founded in 1994, Neighborhood Health Plan of Rhode Island (Neighborhood) is a not-for-profit Health Management Organization (HMO) that partners with the Community Health Centers and others, serving as a catalyst for improved access and better health in Rhode Island. Neighborhood contracts with the state of Rhode Island to administer the RIte Care and Rhody Health Partners programs, and has more than 78,000 members. Neighborhood is rated “Excellent” by the National Committee for Quality Assurance (NCQA) and has ranked as one of the top four Medicaid health plans in America since the inception of NCQA/US News & World Report rankings in 2005.
About HealthEdge
HealthEdge provides the only modern, enterprise-class software platform for healthcare payors. Using the patented HealthRules® software suite, health plans, health insurance companies and other payors can finally respond to new business opportunities and market changes in hours, not months or years, while drastically reducing both IT and operational costs. Leveraging an investment of over $125 million, HealthRules is the most scalable and cost-effective technology in the industry. HealthEdge is the only choice for payors to survive and thrive in the emerging healthcare economy. For more information, please visit www.healthedge.com.
Contact: |
Ray Desrochers |
|