Your Opportunities

Lower Administrative Costs & Maximize Efficiency

Lower your organization’s administrative costs by optimizing operational efficiency.

 

Increase your auto-adjudication rate: Automate manual processes and eliminating waste.

Improve accuracy: HealthRules customers typically reach 99%+ claims accuracy

Accelerate speed: Reduce claims backlog and pay claims faster, improving both provider and member satisfaction

Challenging tasks such as reprocessing claims are accomplished with ease. Cycle time for claim payment remittance is greatly reduced.

Redeploy the saved resources to innovation projects and other important priorities. Accelerate the performance of your organization, delight your members and providers and lower overall administrative expenditures with HealthEdge solutions. 

Work with a next-generation core administrative system, as designated by Gartner in their annual Hype Cycle. 

Elderplan's Success with HealthRules
92.5%
Auto-Adjudication Rate
0
Claims in Backlog >15 Days Old
1.7M
Claims Processed in 2019
Case Study
Lower Administrative Costs & Maximize Operational Efficiency

Headquartered in Brooklyn, New York, Elderplan is a well-established, not-for-profit health plan that leverages HealthRules Payor to maximize their operational efficiency, control administrative costs and embrace an evolving business model.

Blog Post
How 3 Health Plans Took Unique Approaches to Lowering Admin Costs

The more administration costs increase, the tighter margins become, and the less money health plans have to reinvest in crucial differentiators such as customer service, care coordination, new lines of business, and other innovations. With changing regulations and shifting business models putting further pressure on health plans, lowering administration costs is one key area they can and should master. Here’s how three health plans recently took different approaches to lowering their administrative costs.

DEMO VIDEO
HealthRules Payor Automatic Reprocessing

This video highlights the highly flexible and comprehensive automated reprocessing capabilities inherent within HealthRules Payor.

DATA SHEET
Operational Efficiency

The HealthRules Payor core administration processing solution drives new levels of automation, speed and accuracy, enabling customers to reach unparalleled levels of operational efficiency in the face of shifting market dynamics.

The HealthRules Advantage