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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 Garner?

Garner presents a robust platform that leverages vast amounts of data to aid individuals, employers, and health plans in identifying the most suitable medical providers, utilizing one of the nation's largest claims databases, which encompasses over 60 billion records from upwards of 320 million patients. The platform incorporates more than 500 metrics tailored to various specialties to assess provider performance and effectively gauge patient outcomes, all supported by an AI-driven directory that boasts approximately 92% accuracy for essential information like provider contact details and appointment slots. Providers recognized as “Top Providers” comply with rigorous standards that prioritize evidence-based practices, the minimization of unnecessary medical interventions, and the efficiency of costs. Furthermore, users benefit from access to both a mobile application and a concierge service designed to help them locate in-network Top Providers with available appointments, and they may also receive reimbursements for certain out-of-pocket costs incurred for services rendered by these elite professionals. In addition, this cutting-edge platform not only simplifies the search for quality healthcare but also strives to enhance overall patient satisfaction and health outcomes through its carefully curated resources, ultimately fostering a more informed and efficient healthcare experience for all users. As such, Garner stands out as a leader in healthcare navigation, ensuring that patients receive the best possible care tailored to their specific needs.

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

Free
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

Garner

Company Location

United States

Company Website

www.getgarner.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

Categories and Features

Benefits Administration

COBRA Administration
Claims Management
Deduction Management
Disability Insurance Administration
Employee Benefits Administration
FMLA Administration
FSA Administration
Flexible Spending Accounts
For Brokers
For Employers
HIPAA Compliant
Health Insurance Administration
Life Insurance Administration
Online Benefits Enrollment
Premium Billing
Provider Management
Retiree Administration
Retirement Plan Management

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