HealthRules PayerHealthEdge Software
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InsightPro.aiMDI NetworX
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Related Products
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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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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.
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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
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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
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Audience
Companies searching for a Claims Processing solution
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Audience
Health insurance payers, third-party administrators, benefit administrators, and health plans; used by claims, quality assurance, member services/contact-center, and operations teams.
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Support
Phone Support
Supported
24/7 Live Support
Not Supported
Online
Supported
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Support
Phone Support
Not Supported
24/7 Live Support
Not Supported
Online
Not Supported
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API
Offers API
Not Supported
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API
Offers API
Supported
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Screenshots and Videos |
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Pricing
No information available.
Free Version
Not Supported
Free Trial
Not Supported
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PricingFlexible 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
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Reviews/
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Reviews/
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Training
Documentation
Not Supported
Webinars
Not Supported
Live Online
Not Supported
In Person
Not Supported
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Training
Documentation
Not Supported
Webinars
Not Supported
Live Online
Not Supported
In Person
Not Supported
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Company InformationHealthEdge Software
www.healthedge.com
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Company InformationMDI NetworX
Founded: 2014
United States
insightpro.ai/
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Alternatives |
AlternativesNo Alternatives
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Categories |
Categories |
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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
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Integrations
No info available.
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Integrations
No info available.
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