Gartner® recognizes Burgess, a HealthEdge Company*, as a Representative Vendor for prospective payment integrity

“Payers ‘stack’ payment integrity solutions, implementing multiple vendors to sequentially process the same set of claims in order to eke out additional savings with each pass. Stacking multiple solutions offers diminishing financial returns at the cost of more-complicated contract administration and diminished enterprise-wide visibility into performance.”Gartner further explains that by bringing claims services into one interoperable interface, health plans are realizing unprecedented cost-savings and streamlined operations.

HealthEdge’s prospective payment integrity platform, Source, is a single, comprehensive solution that includes:

  • Pricing
  • Editing
  • Auditing
  • Modeling
  • Analytics

“Our approach is all about building a payment ecosystem, bending that entire world of intelligence to prepayment, and fixing issues to create a virtuous cycle that pays claims accurately the first time.” – Ryan Mooney, EVP and GM of Payment Integrity at HealthEdge

The Source team attributes their success in partnering with health plans to an attitude of innovation and perfectionism. With this mindset the Source team is consistently enabling payers to pay claims accurately, quickly, and comprehensively—the first time.

To read more Gartner recommendations on adopting prospective payment integrity practices at your organization, click here for complimentary access to this report. 

Gartner

 

1Source: Adopt Prospective Payment Integrity to Thwart Healthcare Fraud and Improper Claims Payment, Mandi Bishop, February 16, 2022

*Burgess(recently acquired by HealthEdge)

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