Operational efficiency isn’t just another key performance indicator—it’s the base that enables health plans to scale based on industry demands. As payers face mounting pressure to reduce...
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See how over 450 health plan leaders are preparing for 2025!
Learn MoreHealthEdge® continues to deliver leading technology solutions that empower care teams, reduce administrative burden, and support whole-person care. Solving Healthcare’s Hidden Data Disconnect It...
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At HealthEdge®, we are undertaking a structured migration of our systems to Amazon Web Services (AWS). This move reflects the ongoing evolution in healthcare, driven by the need for greater...
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By Alice Zhan, AI team Part 2: Technical Implementation This is part two of a two-part blog series on HealthEdge’s AI Summarizer feature; this post focuses specifically on the feature’s technical...
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Discover how payment integrity analysts use HealthEdge Source to solve complex issues in hours, not months. Real-time data, instant deployment.
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In today’s healthcare environment, care managers are at the heart of improving outcomes for members with complex needs. Yet, the growing volume of documentation, assessments, and free-text notes...
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See what 3,500 consumers say about their healthcare experiences
Read the report!Fax-based communication and the manual work required to process physical documents remain daily challenges for health plan care teams. Communications related to authorizations, appeals,...
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Operating within the U.S. healthcare industry can be challenging. Decades of layered regulations, siloed processes, and a sprawling network of stakeholders have created an environment where...
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In our first blog, we explored how HealthEdge’s AI-powered optical character recognition (OCR) platform is transforming prior authorization and other document-heavy workflows. Now, we’re taking...
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The One Big Beautiful Bill Act (OBBBA) introduces far-reaching, fast-moving regulatory changes that demand adaptability from health plans. Some provisions are already in effect, while additional...
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The healthcare industry is in constant motion. Regulations change and care models evolve, while competitive pressures and member expectations grow more complex every year. For health plans, this...
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Artificial intelligence (AI) is quickly becoming foundational to the future of healthcare. From automating claims reviews to powering proactive care management, AI has the potential to help health...
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I recently had the opportunity to sit down with the HealthEdge Marketing team to understand how they’ve been adopting AI and how that evolution reflects the broader organizational shift toward...
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By Ethan Zhu + Justin Wolkowicz From Burden to Breakthrough: Tackling Document Chaos with AI At HealthEdge, our AI-first approach isn’t about abstract promises. It’s about solving real, persistent...
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At HealthEdge, our AI Team was created with a clear mission: to accelerate the innovation and adoption of AI technologies that deliver real value for both our customers and our internal teams....
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Extensive legislative reform is shifting the healthcare landscape. The One Big Beautiful Bill Act (OBBBA) introduces significant changes to eligibility requirements across Medicaid, Medicare, and...
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The One Big Beautiful Bill Act (OBBBA) is reshaping healthcare, especially for Medicaid and Medicare plans. With tighter budgets, closer oversight, and an emphasis on population health in rural...
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Healthcare payers are under increasing pressure to integrate and unify digital solutions so they can streamline workflows and improve operational efficiency. With the passing of the...
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Increasing rates of claims denials cause operational bottlenecks and financial consequences across the healthcare system. In 2024, the initial claims denial rate rose to nearly 12%. Denied claims...
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Health plans are grappling with the challenge of reducing operating costs without sacrificing clinical outcomes. At the heart of this challenge lies the core administrative processing system...
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