Our Solutions

Third Party Administrators

Third Party Administrators must have the agility to satisfy each of their customers’ unique requirements.

Rapidly tailoring offerings to meet each specific need is critical. TPA’s need flexibility to configure products quickly. Administering the uniqueness of each customer with optimal automation serves to differentiate the TPA from the competition, and contributes to increased operating margins.

AmeriHealth Administrator's Success with HealthRules
30%
Improvement in Auto-Adjudication Rates
99.6%
Financial Claims Accuracy
4 Months
To Onboard a Customer with 300K Lives
Case Study
Agilility & Flexibility in Healthcare Today

AmeriHealth Administrators realized an organizational need for transformation in order to expand and scale the business to new customers. To achieve this, the organization leveraged HealthRules Payor for its agility and flexibility and is realizing significant benefits.

HealthEdge’s HealthRules product suite enables Third Party Administrators to effectively serve their customers with benefits that include:

  • Help customers serve new groups of members quickly in response to market opportunities
  • Meet the specific needs of individual customers with a variety of product offerings
  • Utilize business analysts for configuration and maintenance of new employer plans, saving IT resources
  • Support all types of provider networks and contracts with maximum flexibility and reusable components
  • Reduce administrative cost by automating critical  business processes
  • Deliver transparency of information for superior customer experience and improved member engagement
  • Leverage key data sources with seamless integration

TPAs succeed when they meet customer requirements quickly and easily. Having the flexibility to tackle infinite variations of products and designs is crucial. Only the HealthEdge HealthRules suite provides a TPA with the competitive advantage and latest technology designed to support their business.