HealthRules PayerHealthEdge Software
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Related Products
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About
Garner delivers a data-driven platform that enables individuals, employers, and health plans to identify top-performing medical providers by leveraging one of the largest claims databases in the U.S., over 60 billion records covering more than 320 million patients. It uses more than 500 specialty-specific quality and efficiency metrics to analyze provider performance and diagnose outcomes, and a verified directory powered by AI that achieves approximately 92% accuracy for provider phone, address, and appointment-availability information. Providers flagged as “Top Providers” meet rigorous criteria, including evidence-based treatment, minimized unnecessary procedures, and efficient cost structures. Members can use a mobile app and concierge service to locate in-network Top Providers with available appointments, and when eligible, have certain out-of-pocket costs reimbursed for services rendered by these providers.
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About
HealthRules® Payer is a next-generation core administrative processing system that provides transformational capabilities to health plans of all types and sizes. For more than ten years, health plans implementing HealthRules Payer have been able to quickly address market opportunities and stay in front of their competition. HealthRules Payer is unlike any other core administrative solution because of its use of the patented HealthRules Language™, an English-like vernacular that delivers a revolutionary new approach to configuration, claims processing and transparency of information. HealthRules Payer helps transform health plans looking to grow, innovate and compete beyond any other core system today.
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Platforms Supported
Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook
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Platforms Supported
Windows
Mac
Linux
Cloud
On-Premises
iPhone
iPad
Android
Chromebook
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Audience
Employers, health plans and care-navigation teams interested in a tool to steer members toward high-quality, cost-efficient providers and improve referral decision-making
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Audience
Companies searching for a Claims Processing solution
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Support
Phone Support
24/7 Live Support
Online
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Support
Phone Support
24/7 Live Support
Online
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API
Offers API
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API
Offers API
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Screenshots and Videos |
Screenshots and Videos |
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Pricing
Free
Free Version
Free Trial
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Pricing
No information available.
Free Version
Free Trial
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Reviews/
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Reviews/
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Training
Documentation
Webinars
Live Online
In Person
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Training
Documentation
Webinars
Live Online
In Person
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Company InformationGarner
United States
www.getgarner.com
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Company InformationHealthEdge Software
www.healthedge.com
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Categories |
Categories |
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Claims Processing Features
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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Integrations
No info available.
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Integrations
No info available.
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