Our Solutions

Support for Health Plans With Home and Host Capabilities Nationwide

Health plans with Home and Host capabilities must achieve maximum operational efficiency with modern technology to help eliminate waste and maximize the use of available resources.

Support for Health Plans With Home and Host Capabilities Nationwide

Health plans with Home and Host capabilities have entrusted HealthEdge’s HealthRules® Payor to remain resilient, competitive, and focused on delivering outstanding service to providers, members and groups nationwide. Home & Host capabilities use inter-plan operations that enable members traveling or living in another plan’s service area to receive their at home benefits while away. Participating providers and independent plans across the country are linked electronically for claims processing and reimbursement. To learn more about why one of these plans teamed up with HealthEdge and how HealthRules Payor helped them navigate the COVID-19 pandemic, click here.

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DATA SHEET
HealthRules for Health Plans With Home and Host Capabilities

As well-established leaders in the markets they serve, many health plans with Home & Host capabilities are compelled to seek out modern technologies that can keep pace with their complex business needs and support their market-leading positions. Migrating to the industry’s dominant next-generation core claims and administrative platform can play a key role in these technology strategies.

A modernized Core Administration Processing System (CAPS) is necessary to help plans keep up with shifting landscapes and proactively deploy solutions for the future. HealthRules Payor is a next-generation claims and benefits administration solution that enables plans of all types and sizes to quickly and efficiently launch new lines of business and products while simultaneously achieving high levels of automation and lowering administrative costs. To learn more about why one of these plans teamed up with HealthEdge and how HealthRules Payor helped them navigate the COVID-19 pandemic, click below.

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