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What is HealthRules Payer?

HealthRules® Payer is a state-of-the-art core administrative processing framework that delivers transformative capabilities for health plans of all shapes and sizes. For more than ten years, health plans that have adopted HealthRules Payer have successfully seized market opportunities and sustained a competitive advantage. What distinguishes HealthRules Payer from other core administrative systems is its unique utilization of the patented HealthRules Language™, which closely resembles English and introduces an innovative approach to configuration, claims management, and transparency of information. This exceptional system empowers health plans to grow, innovate, and excel beyond their competitors more efficiently than any other core solution currently available. Consequently, HealthRules Payer not only enhances operational efficiency but also cultivates a culture of adaptability and responsiveness within health organizations, ultimately leading to improved patient care and satisfaction. By integrating advanced tools and methodologies, HealthRules Payer positions health plans to thrive in an ever-evolving healthcare landscape.

What is AUSIS?

AUSIS – Comprehensive Behavioral Underwriting AUSIS equips insurance providers with the ability to perform in-depth underwriting, scoring, and decision-making almost instantaneously. By implementing AUSIS, companies can significantly lower their expenses, time requirements, risk exposure, and instances of fraud, all while enhancing efficiency and decision-making through innovative alternative scoring techniques and added functionalities. Additionally, AUSIS improves the straight-through processing (STP) rate as compared to non-straight-through processing (NSTP) and facilitates non-invasive health data gathering from a multitude of sources, including air quality indexes (AQI), geographic locations, mortality rates, social determinants, multimedia content, health monitoring devices, weather patterns, sanitation conditions, and beyond. As a result of using AUSIS, insurance organizations may see up to a 40% reduction in costs tied to policy issuance. This groundbreaking solution not only optimizes the underwriting workflow but also offers critical insights that can enhance risk assessment and management strategies. The integration of such comprehensive data enhances the overall effectiveness of the insurance process.

Media

Media

Integrations Supported

ABBYY FineReader PDF
AGO Insurance Software
DXC Assure
Document Manager
Ensemble Suite
Google Cloud Platform
IBM Watson Machine Learning Accelerator
Microsoft Azure
PolicyStat
TensorFlow

Integrations Supported

ABBYY FineReader PDF
AGO Insurance Software
DXC Assure
Document Manager
Ensemble Suite
Google Cloud Platform
IBM Watson Machine Learning Accelerator
Microsoft Azure
PolicyStat
TensorFlow

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

$10/month/user
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

HealthEdge Software

Company Website

www.healthedge.com

Company Facts

Organization Name

Artivatic.ai

Date Founded

2017

Company Location

India

Company Website

artivatic.ai/products/ausis

Categories and Features

Claims Processing

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

Categories and Features

Claims Processing

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

Insurance Agency

Claims Management
Commission Management
Contact Management
Document Management
Insurance Rating
Life & Health
Policy Management
Property & Casualty
Quote Management

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

Insurance Policy

Cancellation Tracking
Claims Tracking
Policy Generation
Policy Issuance
Policy Processing
Quotes / Estimates
Rating Engine
Reinstatement Tracking
Reinsurance Administration
Renewal Management
Underwriting Management

Insurance Underwriting and Rating

Broker / Agent Portal
Carrier Upload
Commercial Lines
Comparative Insurance Rating
Customer Portal
For Casualty Insurance
For Health / Medical Insurance
For Life Insurance
For Personal Insurance
Multi-State
Multiple Line Rating

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