{"id":47433,"date":"2022-08-18T14:02:11","date_gmt":"2022-08-18T12:02:11","guid":{"rendered":"https:\/\/pharma-trend.com\/en\/healthedge-named-a-sample-vendor-for-next-gen-core-administrative-processing-and-prospective-payment-integrity-solutions-in-the-gartner-hype-cycle-for-u-s-healthcare-payers-2022\/"},"modified":"2022-08-18T14:02:11","modified_gmt":"2022-08-18T12:02:11","slug":"healthedge-named-a-sample-vendor-for-next-gen-core-administrative-processing-and-prospective-payment-integrity-solutions-in-the-gartner-hype-cycle-for-u-s-healthcare-payers-2022","status":"publish","type":"post","link":"https:\/\/pharma-trend.com\/en\/healthedge-named-a-sample-vendor-for-next-gen-core-administrative-processing-and-prospective-payment-integrity-solutions-in-the-gartner-hype-cycle-for-u-s-healthcare-payers-2022\/","title":{"rendered":"HealthEdge Named a Sample Vendor for Next-Gen Core Administrative Processing and Prospective Payment Integrity Solutions in the Gartner\u00ae Hype Cycle\u2122 for U.S. Healthcare Payers, 2022"},"content":{"rendered":"
\n

BURLINGTON, Mass.–(BUSINESS WIRE)–HealthEdge today said it has again been mentioned as a Sample Vendor for both its Core Administrative Processing (CAPS) and Prospective Payment Integrity (PPI) solutions in the Gartner Hype Cycle for U.S. Healthcare Payers, 2022.i <\/sup>This year is the 12th<\/sup> in a row for HealthEdge to be mentioned as a CAPS Sample Vendor and the fourth consecutive year to be mentioned as a PPI Sample Vendor (formerly Burgess Source).\n<\/p>\n

\n\u201cWe are excited to be recognized by Gartner yet again for these solutions in our next-gen SaaS product suite,\u201d said Alan Stein, Chief Commercial Officer for HealthEdge. \u201cThe industry is embracing digital-based technologies that drive cost savings for health plans while enhancing the evolution of customer engagement. HealthEdge is building on its unique value proposition as an integration solution that enables clients to reduce administrative spend and allows them to focus on strategic organizational goals like client adoption\/satisfaction and care programs that promote health and well-being.\u201d\n<\/p>\n

\nPer the Gartner report: <\/b>\u201cCAPS modernization is a payer strategic imperative that delivers operational improvements and administrative cost savings through increased efficiency and accuracy, freeing funds and resources for innovation. Monolithic legacy CAPS hinder business leaders\u2019 ability to bring new products to market quickly or support regulatory changes. Next-generation CAPS is an incremental step toward composable architecture \u2013 offering modern architecture, flexible delivery models and robust integration options.\u201d\n<\/p>\n

\nHealthRules\u00ae<\/sup> Payor is a next-generation core administrative processing system that provides transformational capabilities to health plans of all types and sizes. Health plans have used it for more than a decade to quickly address market opportunities and stay in front of their competition. The solution is unique in its use of a patented, English-like vernacular that delivers a revolutionary approach to configuration, claims processing and transparency of information.\n<\/p>\n

\nAlso per the Gartner report: \u201cPPI solutions mitigate a broad range of potentially improper claims payment activities \u2013 spanning revenue integrity, payment accuracy and FWA prevention solutions \u2013 by identifying, and correcting for, claims inaccuracies prior to claims payment. The Department of Health and Human Services estimated it paid more than $153 billion in healthcare claims improperly in 2021 and the Department of Justice recovered over $5 billion in fraudulent claims.\u201d\n<\/p>\n

\nThe Source platform provides an interoperable, cloud-based solution designed to deliver rich pricing and editing content, with technology that enables payers to address root-cause issues and unparalleled transparency for control over their payment integrity operations. Its position as a pricer ensures that reimbursement and configurations are accurate, reducing downstream needs for editing suites.\n<\/p>\n

\ni<\/sup>Gartner, \u201cHype Cycle for U.S. Healthcare Payers, 2022,\u201d Mandi Bishop and Connie Salgy, July 2022.\n<\/p>\n

\nGartner Disclaimer
\n
<\/b>Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner\u2019s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose. Gartner and Hype Cycle are registered trademarks and service marks of Gartner, Inc. and\/or its affiliates in the U.S. and internationally and are used herein with permission. All rights reserved.\n<\/p>\n

\nAbout HealthEdge
\n
<\/b>HealthEdge<\/a>\u00ae<\/sup> strives to innovate a world where healthcare can focus on people, advancing a digital revolution in healthcare through transaction automation and enabling real-time business and clinical engagement among payers, providers and members. HealthEdge pursues this mission through the delivery of the HealthEdge Digital Platform, consisting of the health insurance industry\u2019s leading cloud-based SaaS applications for core administration (HealthRules\u00ae<\/sup> Payor<\/a>), payment integrity (Source<\/a>), care management (GuidingCare<\/a>\u00ae<\/sup>), and digital health management and consumer engagement (Wellframe<\/a>). Offered individually and as an integrated suite, HealthEdge Digital Platform applications provide modern, disruptive healthcare IT solutions that enable health insurers to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect key stakeholders in the healthcare delivery cycle. Follow HealthEdge on Twitter<\/a> or LinkedIn<\/a>.\n<\/p>\n

Contacts<\/b> <\/p>\n

\nMedia Contact:<\/b>
Michelle Panico
\n
708-268-3119
\n
healthedge@pancomm.com<\/a>\n<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

BURLINGTON, Mass.–(BUSINESS WIRE)–HealthEdge today said it has again been mentioned as a Sample Vendor for both its Core Administrative Processing (CAPS) and Prospective Payment Integrity (PPI) solutions in the Gartner Hype Cycle for U.S. Healthcare Payers, 2022.i This year is the 12th in a row for HealthEdge to be mentioned as a CAPS Sample Vendor … [Read more…]<\/a><\/span><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[],"class_list":{"0":"entry","1":"post","2":"publish","3":"author-business","4":"post-47433","6":"format-standard","7":"category-industry"},"yoast_head":"\nHealthEdge Named a Sample Vendor for Next-Gen Core Administrative Processing and Prospective Payment Integrity Solutions in the Gartner\u00ae Hype Cycle\u2122 for U.S. Healthcare Payers, 2022 - Pharma Trend<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pharma-trend.com\/en\/healthedge-named-a-sample-vendor-for-next-gen-core-administrative-processing-and-prospective-payment-integrity-solutions-in-the-gartner-hype-cycle-for-u-s-healthcare-payers-2022\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HealthEdge Named a Sample Vendor for Next-Gen Core Administrative Processing and Prospective Payment Integrity Solutions in the Gartner\u00ae Hype Cycle\u2122 for U.S. Healthcare Payers, 2022 - Pharma Trend\" \/>\n<meta property=\"og:description\" content=\"BURLINGTON, Mass.–(BUSINESS WIRE)–HealthEdge today said it has again been mentioned as a Sample Vendor for both its Core Administrative Processing (CAPS) and Prospective Payment Integrity (PPI) solutions in the Gartner Hype Cycle for U.S. Healthcare Payers, 2022.i This year is the 12th in a row for HealthEdge to be mentioned as a CAPS Sample Vendor ... 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