HealthRules Payer

HealthRules Payer

HealthEdge Software
InsightPro.ai

InsightPro.ai

MDI NetworX
+
+

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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.

About

InsightPro is a web-based workforce analytics and operations platform for health insurance payers, third-party administrators, benefit administrators, and health plans. It supports claims operations, quality assurance, and member contact-center teams. Claims features include inventory tracking, task assignment and distribution, production planning, forecasting, KPI dashboards, activity monitoring, and query resolution. Quality teams can use configurable audits, sampling, capacity planning, error feedback, rebuttal workflows, and performance reporting. Contact-center features include member and call-history views, configurable workflows, real-time highlights, and performance analytics. Workforce dashboards help managers monitor productivity, workload, quality, and operational trends, while administrative tools support user and workflow management. The platform is delivered as a configurable SaaS service for payer operations; plan scope and pricing are tailored to customer requirements.

Platforms Supported

Windows Not Supported
Mac Not Supported
Linux Not Supported
Cloud Supported
On-Premises Not Supported
iPhone Not Supported
iPad Not Supported
Android Not Supported
Chromebook Not Supported

Platforms Supported

Windows Not Supported
Mac Not Supported
Linux Not Supported
Cloud Supported
On-Premises Not Supported
iPhone Not Supported
iPad Not Supported
Android Not Supported
Chromebook Not Supported

Audience

Companies searching for a Claims Processing solution

Audience

Health insurance payers, third-party administrators, benefit administrators, and health plans; used by claims, quality assurance, member services/contact-center, and operations teams.

Support

Phone Support Supported
24/7 Live Support Not Supported
Online Supported

Support

Phone Support Not Supported
24/7 Live Support Not Supported
Online Not Supported

API

Offers API Not Supported

API

Offers API Supported

Screenshots and Videos

Screenshots and Videos

Pricing

No information available.
Free Version Not Supported
Free Trial Not Supported

Pricing

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 Version Not Supported
Free Trial Not Supported

Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

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Reviews/Ratings

Overall 0.0 / 5
ease 0.0 / 5
features 0.0 / 5
design 0.0 / 5
support 0.0 / 5

This software hasn't been reviewed yet. Be the first to provide a review:

Review this Software

Training

Documentation Not Supported
Webinars Not Supported
Live Online Not Supported
In Person Not Supported

Training

Documentation Not Supported
Webinars Not Supported
Live Online Not Supported
In Person Not Supported

Company Information

HealthEdge Software
www.healthedge.com

Company Information

MDI NetworX
Founded: 2014
United States
insightpro.ai/

Alternatives

Alternatives

No Alternatives
PlanXpand

PlanXpand

Acero Health Technologies
PLEXIS Payer Platforms

PLEXIS Payer Platforms

PLEXIS Healthcare Systems
InsightPro.ai

InsightPro.ai

MDI NetworX

Categories

Categories

Claims Processing Features

Adjustor Management Not Supported
Case Management Not Supported
Claim Resolution Tracking Not Supported
Co-Pay & Deductible Tracking Not Supported
Compliance Management Not Supported
Customer Management Not Supported
Electronic Claims Not Supported
Forms Management Not Supported
Paper-Based Claims Not Supported
Payor Management Supported
Policy Administration Not Supported

Integrations

No info available.

Integrations

No info available.
Claim HealthRules Payer and update features and information
Claim HealthRules Payer and update features and information
Claim InsightPro.ai and update features and information
Claim InsightPro.ai and update features and information