Health plans ready to embark on the road to transformation are turning to HealthRules solutions.
HealthRules solutions allow health plans to control administrative costs with maximum efficiency, lower healthcare costs and maximize revenue while embracing new business models. The suite of solutions also allows health plans to improve outcomes and the quality of care through transparent coordination among utilization management, case management, disease management and health and wellness functionality.
HealthEdge services provide health plans with a deployment road map, along with continuing resources to ensure your ongoing success. The powerful combination of people, process and technology is evidenced across the continuum of HealthEdge's products and services.
Navigate below to learn more about our products and services.
Andy Slavitt, former Acting Administrator, Centers for Medicare and Medicaid Services, talks about the evolution of the role of payers, from that of a fiduciary entity to a unique role that touches patient, provider and all other ancillaries.

Next-generation claims and benefits administration solution to address today's healthcare economy
A patented, English-like healthcare-specific vocabulary. Your rules, in your language
Engage members and patients and manage care in the most efficient ways possible
State-of-the-art, web-based business intelligence designed to transform how payers see and use data
Link everyone involved in healthcare delivery with a rich set of self-service tools
A robust integration layer that delivers the right information, in the right place, at the right time
Customer-facing teams serve all your needs, from strategic planning to day-to-day requests, and everything in between
HealthEdge teams ensure that implementations are successful and strive to take the risk and variability out of projects
Comprehensive training designed to the maximize the use of HealthRules