Health Rules Payer Platform Data Sheet

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Data Sheet: HealthRules Payer Platform Overview

(3 days ago) WEBData Sheet: Navigating the No Surprises Act - The Right Tools for Health Plan Success HealthRules Payer® is a modern and flexible core administrative processing system that …

https://healthedge.com/resources/data-sheets/healthrules-payer-data-sheet

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Auto-Adjudication Feature HealthRules Payer

(Just Now) WEBThat’s why HealthRules Payer has been ranked number one in its class among core administration platform solutions. Besides delivering 90%–97% first-pass auto-adjudication rates and 99%+ accuracy, it …

https://healthedge.com/solutions/core-administrative-processing-systems/healthrules-payer/

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Data Sheet: HealthRules Language

(6 days ago) WEBData Sheet: Navigating the No Surprises Act - The Right Tools for Health Plan Success HealthRules Payer® is a modern and flexible core administrative processing system that …

https://healthedge.com/resources/data-sheets/healthrules-language-data-sheet

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HealthRules® Answers HealthEdge

(2 days ago) WEBReal-Time Data Warehouse. The data warehouse offers a real-time repository of claims, financial, membership and provider data that payers can analyze to monitor any operational parameter. English-like …

https://healthedge.com/solutions/core-administrative-processing-systems/healthrules-answers/

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Demo Video: HealthRules Payor Data Transparency

(7 days ago) WEBHealthRules Payor Data Transparency. Note: We recommend watching the Introduction to HealthRules Payor demo before any of the others in this series. This video shows how HealthRules Payor can provide real-time …

https://go.healthedge.com/health-rules-payor-demo-video-data-transparency-download.html

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HealthRules Payor + Burgess Source Combined Value

(8 days ago) WEBdata, pricing, editing, real-time analytics, claims modeling tools, and sophisticated network payment configuration in a single source. As part of HealthEdge’s integrated next …

https://go.healthedge.com/rs/803-KIL-291/images/HE21_BS21_HRPandBurgessAdvantages_DS.pdf

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HealthRules® Payer – Exciting New Features & Improvements

(4 days ago) WEBThe HealthRules ® Payer engineering team has been working on several critical projects, and the January 2024 release of the solution is packed with new …

https://healthedge.com/resources/blog/hrp-healthrules-payer-exciting-new-features-improvements

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HealthRules Home and Host Processing HealthEdge HealthEdge

(1 days ago) WEBCore Administrative Processing System (CAPS) If your organization is like many health plans with home and host capabilities, you have a growing need for greater agility – to …

https://healthedge.com/solutions/core-administrative-processing-systems/healthrules-home-and-host-capabilities/

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How Health Plans Connect: Payer-to-Payer Data Sharing - CAQH

(6 days ago) WEBCreating a shared service testing model allows health plans to exchange and test data related to the payer-to-payer data exchange use case. This testing model can also be …

https://www.caqh.org/hubfs/43908627/drupal/2023-03/FINAL%20Insights%20-%20FHIR%20PLAN%20Focus%20Group%20Brief_v5.pdf

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HRP Data Sheet - HealthEdge

(Just Now) WEBWith the HealthRules Language, payers define the rules, terms, and business logic that is easily understood by everyone. The unique characteristics of the HealthRules Language …

https://go.healthedge.com/rs/803-KIL-291/images/HE21_CompetitivePressures_ExecSurvey_Infographic.pdf

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HealthRules Payor Customer Reviews 2024 SoftwareReviews

(8 days ago) WEBHealthRules Payor features the patented HealthRules Language, a revolutionary approach to configuration, claims processing and transparency of information that leverages an …

https://www.softwarereviews.com/products/healthrules-payor

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Providers and Health Plans Connect to Fast Track Prior - Epic

(9 days ago) WEBUsing Payer Platform, Mayo Clinic and Blue Cross Blue Shield of Minnesota (BCBS MN) reduced denials due to additional documentation requests (ADR) …

https://www.epic.com/epic/post/providers-and-health-plans-connect-to-fast-track-prior-authorization-claims-and-quality-reporting/

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EDI Gateway Healthcare Transaction Processing HealthEdge

(4 days ago) WEBThe integration between HealthRules Payer and Source creates a new level of operational efficiency and accuracy in claims pricing and editing. With the continuous management …

https://healthedge.com/solutions/core-administrative-processing-systems/healthrules-connector/

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Payer-to-Payer Data Exchange CMS - Centers for Medicare

(4 days ago) WEBPayer-to-Payer Data Exchange. Is CMS still exercising enforcement discretion for the payer-to-payer data exchange provisions of the May 2020 …

https://www.cms.gov/priorities/key-initiatives/burden-reduction/faqs/payer-payer-data-exchange

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HealthRules Payer (HRP) Video: Implementation & What to Expect

(7 days ago) WEB38:36 Webinar: HealthEdge Source™ - Avoiding Payment Integrity Pitfalls The traditional approach to payment integrity stacks multiple claims editors and incentivizes catching …

https://healthedge.com/resources/videos/hrp-implementation-and-what-to-expect

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HealthRules® Payer Named "Best in KLAS" for Third Consecutive …

(9 days ago) WEBBURLINGTON, Mass., February 07, 2024--HealthRules® Payer from HealthEdge has been recognized for the third straight year as the "Best in KLAS" Claims & Administration …

https://finance.yahoo.com/news/healthrules-payer-named-best-klas-130000188.html

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Epic Interoperability Fact Sheet - ONC

(Just Now) WEBEpic Interoperability Fact Sheet. Epic is the most widely used electronic health record (EHR) system in the U.S. and one of the most interoperable, supporting …

https://www.healthit.gov/sites/default/files/facas/GSG_TestimonySupport_CarlDvorak_2014-08-15_04.pdf

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Payer Workflows: Prior Authorization Support and Payer

(Just Now) WEBThe benefits of Prior Authorization Support, a use-case defined by the DaVinci Project, include: Payer Coverage Decision Exchange and the Role of an Integration Engine. …

https://rhapsody.health/blog/2-payer-workflows-using-an-integration-engine-prior-authorization-support-and-payer-coverage-decision-exchange/

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CMS Rule Interoperability Mandate for Payers - Biometric Health

(9 days ago) WEBCMS recently introduced new interoperability mandates for health plans that must be implemented by July 1, 2021. These include: Patient Access Rule - FHIR® for members …

https://www.biometrichealth.org/services/cms-rule

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