HealthRules Payer Commentary

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We've had some challenges with HealthEdge since their merger with UST HealthProof. There have been...

HealthEdge is losing people through their merger with UST HealthProof. The reason we went with UST...

HealthEdge’s road map is pretty nonexistent or so high-level that it doesn't have any timelines...

HealthEdge wasn’t automating our workflow, but we are getting ready to get into some of that....

There were lots of starts and stops with the implementation of HealthRules Payer. It was a disaster....

I don't know that HealthEdge has ever even offered us any training, and we know more about the...

HealthEdge's support for HealthRules Payer has always been quite bad. We talk about things on our...

HealthEdge has work item routing for the solution. We don't have it live yet, but that will help...

I'm really on the fence about whether I would buy HealthRules Payer again. Sure, I would buy it...

It depends on who we talk to as to whether tickets are resolved in a timely manner. Sometimes I have...

I rate HealthEdge lower on partnership compared to another vendor we work with that we’re closer to,...

The functionality of HealthRules Payer doesn't meet all our needs. It's an application that has many...

Depending on what someone is looking for, if they know what the downsides are, HealthRules Payer is...

HealthRules Payer doesn’t do pharmacy adjudication. Pharmacy benefits are adjudicated in a...

There are functions that I would like HealthEdge to develop for the solution. For example, from an...

The training is honestly lacking for HealthRules Payer. We got the software, and then we just had to...

HealthRules Payer is a great core processing system, but for billing, we have to go outside and use...

We partner with HealthEdge on solutions to problems, or we take a lot of solutions to them, and they...

I'm very pleased with HealthRules Payer. It is a workhorse when it comes to processing claims. But...

We had to develop our own training around HealthRules Payer for our users and frontline users, but...

HealthRules Payer is expensive, but worth it. I know the claims are being processed, there’s system...

We made the decision to go with HealthEdge because we needed to have a solution that was scalable...

I'm very supportive of HealthEdge. They have a lot of priorities, so their plan is complex to execute....

HealthEdge's products aren't aligned with each other. They're all very complicated. The members of...

The biggest impact for me would be for HealthEdge to get organized on product versus implementation...

Our current implementations with HealthEdge are all hard. We're really struggling with defects and...

HealthEdge's CEO is very smart and works very hard. His primary focus is on delivering the value...

There is an upgrade where we are hoping to get to a version of HealthRules Payer that has more...

HealthRules Payer has a more user-friendly configuration than other systems. Users don't have to be...

HealthEdge is pretty good. We have weekly calls with our account liaison. If we need something to be...

I would tell HealthEdge to continue to do what they are doing. They are improving each year. Our...

The key for us when we first decided to use the system was that we had an automatic adjudication...

The product doesn’t meet all our needs, but to be fair, that is more on the payers than on the...

HealthRules Payer is a good system now. There are pros and cons to it. HealthEdge doesn’t have the...

HealthEdge wants to build AI into their suite to simplify our customer service calls and claims...

HealthEdge has never treated us like we are anything less than a big client. We have been treated...

We leverage HealthRules Connector for integrations with other systems, and it allows us to automate...

HealthEdge is certainly always looking at ways to advance, and they are very knowledgeable when it...

Typically, we bring in paid services through HealthEdge when we do larger upgrades to make sure that...

Sometimes, there is a lot of back and forth on our tickets, and we receive delayed responses from...

HealthRules Payer is highly configurable, and it really meets our needs. We have a very high...

We are really interested in HealthEdge's hosted SaaS solution. The vendor doesn't currently have a...

If I were starting a small, standalone health plan and were going to have a lot of complexity in...

A lot of things could be smoother and could integrate better, but that isn't necessarily all...

I don't have regular touch points with anyone at HealthEdge, but if I need them, I can reach out,...

Outside of whatever just comes out of the box, I wouldn't really say that HealthEdge is automating...

Talking about delivering new technology and actually delivering it are two different things....

For the most part, I don't go to the account manager anymore. I go above them to a vice president....

Sometimes we find an issue, and HealthEdge will tell us that another account had the same issue, and...

HealthEdge used to really peck us a lot and nickel-and-dime us. They aren't as bad as they used to...

HealthEdge’s reporting and analytics are not that great. They have an EDW that they propagate from...

HealthEdge is doing a fair job of modernizing our system. The end users like it. We have some custom...

HealthEdge doesn't support the new CMS mandate that has come out at all. The last product we were on...

HealthEdge has a concept for the claims so that when a claim pends, it doesn't adjudicate for...

As a claims system, HealthRules Payer does pretty well, but that isn't what we use the system for....

I would like to see HealthEdge look at a health plan ecosystem beyond claims processing and think...

HealthRules Payer was a very costly investment, but it does work as designed. The investment piece...

HealthEdge’s support is pretty responsive. What is going well with HealthEdge is that our account...

The HealthRules Payer system is performing as expected with high accuracy in claims processing....

We are moving to the cloud, so I look forward to having more recent and frequent upgrades to stay on...

HealthEdge has an intention to be focused on AI and automation. We do that outside of the system. We...

HealthEdge is way better than when we started.