Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
HealthRules® Payer represents a cutting-edge core administrative processing system that offers transformative features for health plans across various types and sizes. For over a decade, health plans utilizing HealthRules Payer have effectively capitalized on market opportunities, maintaining a competitive edge. What sets HealthRules Payer apart from other core administrative solutions is its innovative application of the patented HealthRules Language™, which resembles English and introduces a groundbreaking methodology for configuration, claims management, and information transparency. This system empowers health plans by enabling them to expand, innovate, and outperform their peers more effectively than any other core system available today. As a result, HealthRules Payer not only streamlines operations but also fosters a culture of agility and responsiveness within health organizations.
Description
InsightPro is an online platform designed for workforce analytics and operations specifically aimed at health insurance payers, third-party administrators, benefit administrators, and health plans. It facilitates claims management, quality assurance, and support for member contact-center teams. The claims functionalities encompass inventory tracking, task allocation and distribution, production planning, forecasting, KPI dashboards, activity surveillance, and query resolution capabilities. Quality assurance teams are equipped with tools for configurable audits, sampling, capacity planning, error feedback mechanisms, rebuttal workflows, and performance reporting options. The platform's contact-center capabilities include access to member and call-history views, adjustable workflows, real-time insights, and performance analytics. Additionally, workforce dashboards enable managers to oversee productivity, workload, quality, and operational trends, while administrative features aid in user and workflow management. As a SaaS solution, this platform is customizable to meet the unique operational needs of payers, with pricing and plan scope tailored according to customer specifications, ensuring flexibility and adaptability in service delivery. This comprehensive suite of features empowers organizations to enhance their operational efficiency and improve overall service quality.
API Access
Has API
No
API Access
Has API
Yes
Integrations
No details available.
Integrations
No details available.
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Pricing Details
Flexible payment options include monthly plans and pay-per-transaction billing. SaaS pricing is tailored to selected features and customer requirements; no long-term commitment is required.
Free Trial
No
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Customer Support
Business Hours
No
Live Rep (24/7)
No
Online Support
No
Types of Training
Training Docs
No
Webinars
No
Live Training (Online)
No
In Person
No
Types of Training
Training Docs
No
Webinars
No
Live Training (Online)
No
In Person
No
Vendor Details
Company Name
HealthEdge Software
Website
www.healthedge.com
Vendor Details
Company Name
MDI NetworX
Founded
2014
Country
United States
Website
insightpro.ai/
Product Features
Claims Processing
Adjustor Management
No
Case Management
No
Claim Resolution Tracking
No
Co-Pay & Deductible Tracking
No
Compliance Management
No
Customer Management
No
Electronic Claims
No
Forms Management
No
Paper-Based Claims
No
Payor Management
Yes
Policy Administration
No
Product Features
Alternatives
Alternatives
No Alternatives