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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 CoverSelf?

CoverSelf has introduced a cutting-edge, cloud-based platform designed to enhance claims accuracy in the healthcare industry, employing the latest in software development techniques. This state-of-the-art solution empowers users to achieve long-term success by effectively adapting to ongoing shifts in claims and payment inaccuracies, which helps reduce obstacles and administrative costs. By facilitating open collaboration among all stakeholders dedicated to addressing claims inconsistencies and operational inefficiencies, the platform promotes quicker customization, innovation, and deployment. Additionally, CoverSelf’s payment integrity system harnesses modern technologies to address payment leaks and inaccuracies, all while ensuring a high degree of transparency and accessibility for payers. The platform encourages the development of new scenarios and data mining algorithms, thus fueling product innovation and expediting customization processes within a specialized framework that boosts the pace of innovation. Furthermore, it automates claim correction and processing, removing the need for additional human input, which leads to even greater operational efficiency. This holistic approach not only streamlines the claims process but also plays a crucial role in enhancing overall healthcare operations and outcomes. Ultimately, by integrating these advanced features, CoverSelf positions itself as a leader in transforming claims management within the healthcare sector.

Media

Media

Integrations Supported

Additional information not provided

Integrations Supported

Additional information not provided

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
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

CoverSelf

Company Location

United States

Company Website

www.coverself.com

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

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