Payment
Accuracy Edge
Payment Accuracy Edge (formerly HealthEdge Source™) ensures accurate payments in real-time—uniting prospective editing, pricing, and analytics in one cloud-native platform that stops leakage before it happens, ensuring accurate payments for continuous cost containment through transformative payment integrity solutions.
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How Payment Accuracy Edge Works for You
Payment Accuracy Edge delivers value across the enterprise—from operations to finance to technology—on one connected platform.
Operations
Cut manual rework and vendor hand-offs with automated, prospective payment review built into the claims flow.
- Fewer pended and reworked claims
- Automated clinical validation
- Configurable payment rules
Finance
Protect margin by preventing overpayments before they go out the door—not chasing them afterward.
- Up to 30% lower administrative cost
- Reduced payment leakage
- Real-time financial impact insight
Technology
A secure, cloud-native platform with automatic content updates and open APIs—no heavy IT lift.
- Cloud-native SaaS delivery
- Automatic content updates
- Open, API-first integration
Pre-Payment Review
Catch coding and clinical errors before payment with real-time edits and automated validation, so claims pay accurately the first time.
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Real-time coding edits
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Automated clinical validation
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Configurable payment rules
Post-Payment Audit
Recover payment leakage that slips through with retrospective analysis and automated recovery workflows across vendors and providers.
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Retrospective claims analysis
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Recovery workflow automation
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Vendor & Provider reconciliation
Reporting & Insights
Turn payment data into action with dashboards that surface leakage trends and root causes, exportable for audit and compliance.
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Leakage trend dashboards
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Root-cause categorization
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Exportable audit reports
Payment Accuracy Edge Solution Suite
Enterprise
Transformation
Ensuring accurate payments for continuous cost containment through end-to-end payment integrity solutions.
Reimbursement
Transformation
Unites Medicare, Medicaid and Commercial pricing with editing in one configurable engine, giving health plans the power to model, monitor and correct payment impact—not just calculate it.
Platform
Access
Gives health plans more transparency and control—a complete editing library, custom edit creation, and embedded analytics in one platform.
Reduce Payment Leakage Before It Happens
Health plans using Payment Accuracy Edge cut administrative cost by up to 30% and pay more claims right the first time.