HealthEdge’s HealthRules Payor Ranked #1 in CAPS and Named ‘Best in KLAS’

Top-Performing Core Administrative Processing Platform Earns Praise from Payers

BURLINGTON, Mass.--(BUSINESS WIRE)--
HealthEdge Software, provider of the industry’s leading next-gen integrated solution suite for health insurers, said today its HealthRules Payor® solution has been named “Best in KLAS” by KLAS Research for claims administrative processing system (CAPS). The designation is awarded by KLAS based on in-depth interviews with payers using the platform. A KLAS Performance Report released last fall showed HealthRules Payor leading the market in new purchase decisions by payers in a 24-month period.

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“We are delighted to earn this respected recognition from our customers,” said Steve Krupa, HealthEdge Chief Executive Officer. “This correlates with what we have heard across the market from customers, who tell us they need the capability to scale and grow membership, expand into new markets, model new benefit plans and connect real-time data access. As digital innovators, we constantly strive to deliver these mission-critical advantages to payers.”

The KLAS Performance Report also ranked HealthRules Payor as “best technology option” based on interviews with a highly satisfied customer base. The “Best in KLAS” designation interviews produced customer comments, noting robust configurability and flexibility:

“I have been through multiple claims systems, and HealthRules Payor is by far one of the best claims systems that I have seen in the marketplace. The ease of use and ease of configuration have been amazing. I speak all the time with our vice president of claims, and they can’t swear enough by the product and what it has done for us.” Vice President, August 2021

“I like the way HealthEdge has built their technology with APIs. I like the ease of APIs to do integrations that we don’t have with a lot of the other systems.” Director, August 2021

HealthEdge’s Chief Operating & Product Officer, Sagnik Bhattacharya, noted that market factors such as the growth of value-based care contracts and new regulations over the past two years have exposed inefficiencies in legacy architecture for many payers: “Legacy technology is getting in the way of the business agility health plans need. HealthRules Payor enables plans to innovate rapidly as they transform to become digital-first businesses.”

Customers expressed appreciation for the HealthEdge culture and collaborative style:

“HealthEdge appears to be at the forefront of the industry. There is new legislation coming out, and the vendor is proactively updating their solution to support some of the mandated functionality. HealthEdge proactively reaches out to their clients through different forums to get input, form solutions and raise awareness.” Vice President, August 2021

“The executive team is high energy. They lean in. They are collaborative … they live their mission of wanting to support our industry, and that shows in every interaction. HealthEdge has done a nice job of building relationships across the organization.” Vice President, August 2021

An October 2021 KLAS Performance Report noted, “HealthEdge has recently seen increased attention from both small and large health plans, who view the vendor’s technology as innovative and who have been asking KLAS for vendor insights.”

The “Best in KLAS” award will be presented to HealthEdge live at HIMSS in Orlando this March. Read the 2022 Best in KLAS: Software & Services report here and the October 2021 KLAS Performance Report about HealthEdge here.

About HealthEdge

HealthEdge® strives to innovate a world where healthcare can focus on people, advancing a digital revolution in healthcare through transaction automation and the enablement of real-time business and clinical engagement among payers, providers and members. HealthEdge pursues this mission through delivery of the HealthEdge Digital Platform, consisting of the health insurance industry’s leading cloud-based SaaS applications for core administration (HealthRules Payor®), payment integrity (Source®), care management (GuidingCare®), and digital health management and consumer engagement (Wellframe). Offered individually and as an integrated suite, HealthEdge Digital Platform applications provide modern, disruptive healthcare IT solutions that enable health insurers to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect each of the key stakeholders in the healthcare delivery cycle. Follow HealthEdge on Twitter or LinkedIn.

About KLAS

KLAS is a data-driven company on a mission to improve the world’s healthcare by enabling provider and payer voices to be heard and counted. Working with thousands of healthcare professionals, KLAS collects insights on software, services and medical equipment to deliver reports, trending data and statistical overviews. KLAS data is accurate, honest and impartial. The research directly reflects the voice of healthcare professionals and acts as a catalyst for improving vendor performance.

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Corrie Fisher
[email protected]

Source: HealthEdge Software