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HEALTHEDGE
Driving substantial outcomes and efficiencies
Partnering with HealthEdge to help customers with end-to-end implementation, optimization, and operational capabilities
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HEALTHEDGE
Looking to implement HealthEdge product suite? Look no further
We provide end-to-end services including pre-implementation assessment, roadmap creation to post-implementation support and optimization.
Smart Start / Assessment
Implementation planning and budgeting
Implementation program and workstream management
Configuration
Integration
Data conversion
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Testing (all phases)
Data & reporting
Change management and training
Ongoing support
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BPaaS (full or functional)
Case Study
Seamless HealthRules Payer migration at scale
Enabled migration of Wisconsin Medicaid to HealthRules Payer, unifying platforms, modernizing integrations, and strengthening compliance, scalability, and early performance gains.
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Case Study
Enabling integrated
care through FIDE SNP transformation
Enabling FIDE SNP transformation through HRP migration, strengthening compliance, improving care coordination, and enhancing experiences for dual-eligible members.
Case Study
Driving enterprise-scale HRP adoption and operational efficiency
Reimagining processes and enabling organization-wide readiness to accelerate adoption, improve efficiency, and drive sustained operational stability post-transformation.
Case Study
Seamless enterprise migration across Commercial, Medicare, and Medicaid
Executing a complex, multi-line transformation to improve scalability, streamline operations, and significantly reduce manual effort across core Payer workflows.
Case Study
Implemented HRP to serve 600K+ members
Migrated 127+ benefit plans for a health system to HRP. Flexible workflows and rules boosted the claims auto-adjudication rate to 90% and led to a 40% reduction in time to market for new health plan launches.
Case Study
Implemented payment integrity business rule engine
Implemented Drools for agile configuration and management of business rules engine, supporting 200+ Payers. Achieved 85% faster processing and 6.5x system efficiency improvement.
Maximize your ROI with our proven expertise
HealthEdge certified BA/TA resources
SmartStart – assessment framework with capability matrix
Vantage – rapid claims backlog reduction service
HealthSAT – test data automation tool
