Infographic: HealthEdge Testing as a Service for HealthRules® Payer
From consultant-led testing to intelligent testing by HealthEdge
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Latest Content
Check out our content to gain valuable insights and strategies to leverage digital solutions to achieve your organizational goals.
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Data Sheet: Maximize Care Team Capacity for Complex Populations with Haven AI
Haven is built on GuidingCare's native data model, no data leaves the platform, no third-party needs to learn your members. The intelligence is already inside your system.
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Ethical AI: Bias and Fairness — Definitions, Sources, and Challenges
Introduction This is part 2 of a series on Ethical AI. The content was adapted from an internal learning and development session developed by the Machine Learning Engineers at HealthEdge®, focused...
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Safeguarding HEDIS Compliance: 5 Strategies for Post-Hybrid Review Documentation and Audit Support
Key Takeaways Post-hybrid review is a critical audit readiness phase: Success depends on strong documentation workflows, accurate validation, and timely support for auditor requests. Centralized...
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Webinar: Funding the Mission: Reduce Waste in Risk Adjustment
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When Patients Turn to AI First: What It Means for Health Plans
Healthcare consumers are changing how they seek information, and increasingly, they are turning to artificial intelligence to do it. Tools powered by generative AI, including platforms like...
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Podcast: Current Trends For Payers - The Tech Debt Dilemma: Why Cloud Operations Are Essential
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HealthEdge Source™ Ranked Best in KLAS for Pre-Payment Accuracy and Integrity Solutions (Payer)
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Podcast: Current Trends for Payers - Rethinking Total Cost of Ownership in Core Admin
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Podcast: Current Trends For Payers - The Human Side of Workflow Technology
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Podcast: Current Trends for Payers - Removing Data Siloes 360 Member Journey
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Podcast: Current Trends for Payers - From Siloes to Synergy: The Power of a Data Hub
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Podcast: Current Trends for Payers - No Analysts Needed
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The HealthEdge® Commitment: Three Outcomes We Guarantee
Key Takeaways HealthEdge centers every product innovation around delivering three core outcomes: lower-risk implementations in less time, higher quality at a lower cost, and continuous innovation...
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When Your Legacy Operating Model Costs More to Maintain Than to Modernize
Key Takeaways For payers, inaction is not a neutral choice—legacy operating models carry compounding costs that erode financial performance, member satisfaction, and competitive positioning over...
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Combat the Hidden Costs of Vendor Sprawl with Performance Management
Key Takeaways For health plans, managing multiple vendors can create compounding operational inefficiencies that inflate costs and impede decision-making. A single integrated technology...
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Brochure: Balancing the Equation - How Health Plans Can Optimize MLR and ALR in a Complex Healthcare Landscape
Every premium dollar a health plan collects must be carefully divided between medical care, administrative operations, and margin.
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AI Capabilities: Transforming Payer Strategies with HealthEdge
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eBook: NCQA Certification is Becoming a Defining Test for Health Plans
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How NorthWinds Technology Solutions Reached 90% Auto-Adjudication with HealthRules® Payer AI
Efficiencies in claims processing is a direct driver of cost management, member satisfaction, and competitive positioning. NorthWinds Technology Solutions leadership understood this when they made...
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Closing the Gap: Leveraging Hybrid Records to Propel Medicare Advantage Plans to 5 Stars
Achieving a 4.5-Star rating is a major accomplishment for any Medicare Advantage health plan. But moving from 4.5 to 5 Stars is a different challenge altogether. Only a small percentage of plans...
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