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ease
features
design
support

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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

Create, enhance, sustain, and market your network all through a single integrated platform. Utilize competitive insights to bolster your market position effectively. Standardize and refine provider information to facilitate easier searches. Evaluate network performance using metrics related to accessibility, cost, and quality. Provide engaging and feature-rich solutions for provider searches. Gain a deeper understanding of your network's financial health. Construct and improve networks that are competitive, accessible, and provide high value to capture market share and fulfill the needs of your members. Monitor competitor movements and market prospects to sharpen your network strategy, pinpoint optimal providers to stay competitive, and convey the strengths of your network. Simplify your provider directory, plan design, and benefit consulting through quicker and more dependable provider network data. Design tailored networks that align with each client's specific objectives, risk tolerance, and desired provider access, ensuring a comprehensive approach to network management. This complete suite of features not only enhances operational efficiency but also strengthens your overall market presence.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

HealthEdge Software

Website

www.healthedge.com

Vendor Details

Company Name

Zelis

Founded

2016

Country

United States

Website

www.zelis.com

Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

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