Products & Services

The HealthRules suite of solutions is the only integrated financial, administrative and clinical software platform for all types and sizes of health plans. HealthRules is a set of cutting-edge software products that work independently or together, and are complemented by a comprehensive set of available services. HealthRules connects everyone in the healthcare delivery cycle.

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.

The Role of the Payer in Uncertainty, with Andy Slavitt

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. 

Explore Our Products & Services
HealthRules Payor

Next-generation claims and benefits administration solution to address today's healthcare economy

HealthRules Language

 A patented, English-like healthcare-specific vocabulary. Your rules, in your language

HealthRules CareManager

Engage members and patients and manage care in the most efficient ways possible

HealthRules Answers

State-of-the-art, web-based business intelligence designed to transform how payers see and use data

HealthRules Portal Integration Kit

Link everyone involved in healthcare delivery with a rich set of self-service tools

HealthRules Connector

A robust integration layer that delivers the right information, in the right place, at the right time

Account Management

Customer-facing teams serve all your needs, from strategic planning to day-to-day requests, and everything in between

Implementation Services

HealthEdge teams ensure that implementations are successful and strive to take the risk and variability out of projects

Education Services

Comprehensive training designed to the maximize the use of HealthRules