HealthRules Payer Commentary
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Subject Expert
Boyd Stewart
Vice President of Payer/Provider Collaboratio
KLAS Vice President of Payer/Provider Collaboratio - Boyd Stewart
 
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User Commentary

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VP/Other Executive

Loyalty, Product

I am probably selling the vendor's new technology short because some of that new technology would...

Jun 2024
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VP/Other Executive

Loyalty

HealthEdge's product is good, but people need to have the right expectations. HealthEdge isn't...

Jun 2024
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VP/Other Executive

Relationship

I don't want to paint HealthEdge in a bad light because their product is great and the people who...

Jun 2024
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VP/Other Executive

Relationship

Whether we get our money's worth is mostly driven by the vendor's professional services team. That...

Jun 2024
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VP/Other Executive

Relationship

I would give the vendor a low rating for proactivity. That is an area where the vendor could...

Jun 2024
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VP/Other Executive

Product

We would like to have more control over the system. At the same time, using HealthRules Payer is a...

Jun 2024
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VP/Other Executive

Loyalty, Product

There are definitely a lot of good things in HealthRules Payer. The vendor will move things to the...

Jun 2024
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VP/Other Executive

Operations, Product

Our recent upgrade with HealthRules Payer was the worst one we have ever been through. It was a...

Jun 2024
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VP/Other Executive

Loyalty, Product

HealthRules Payer is the core of things, but we can build other components around it to give our...

Jun 2024
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VP/Other Executive

Relationship

We would buy HealthRules Payer again. The only reason I would hesitate would be that we need...

Jun 2024
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VP/Other Executive

Loyalty, Product

The system's user interface could use a bit of an upgrade to make it more web based and easier to...

Jun 2024
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VP/Other Executive

Product, Value

The operational efficiency improvements from HealthRules Payer really come in terms of the...

May 2024
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VP/Other Executive

Loyalty, Product, Value

There are files that are required for the transparency in coverage rule, and they are...

May 2024
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VP/Other Executive

Relationship

HealthEdge has really stepped up their executive involvement. However, I think everything comes down...

May 2024
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VP/Other Executive

Relationship, Operations

One area where we face challenges with HealthEdge is communication. HealthEdge created a new...

May 2024
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VP/Other Executive

Product

HealthEdge’s product is decent, but we had a bad upgrade that had a lot of issues, and that reduced...

Apr 2024
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VP/Other Executive

Product, Value

HealthRules Payer doesn't have a robust reporting system. We had to take the reporting offline. We...

Apr 2024
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VP/Other Executive

Product

HealthEdge is good on the Medicare commercial side. Medicaid is a bit of a weak area, and we had to...

Apr 2024
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VP/Other Executive

Value

HealthRules Payer is an expensive system that takes a lot to support and run. On the back end, it is...

Apr 2024
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VP/Other Executive

Operations

Regarding implementations, HealthEdge misses the mark in terms of quality and timeliness. Sometimes,...

Apr 2024
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VP/Other Executive

Product

Ease of use is probably one of HealthEdge’s strengths. HealthRules Payer is a modern system that...

Apr 2024
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VP/Other Executive

Relationship

HealthEdge is reactive. They could improve their testing processes and general promptness in...

Apr 2024
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VP/Other Executive

Loyalty

Sometimes, the vendor's plans get squashed. For example, HealthEdge said they were going to have a...

Apr 2024
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VP/Other Executive

Relationship

We have been with HealthEdge a long time, so the support might be a little bit better We have been...

Apr 2024
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VP/Other Executive

Loyalty

HealthEdge has a product called Care-Payer. We are upgrading our other HealthEdge products to make...

Apr 2024
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Manager

Product, Value

We can configure our stuff into a ton of manual processes with HealthRules Payer, and HealthEdge...

Apr 2024
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VP/Other Executive

Product

Before we moved to HealthRules Payer, I couldn't break a certain number on the adjudication system...

Feb 2024
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VP/Other Executive

Loyalty, Value

We looked at one of HealthEdge's competitors. At that time, HealthEdge seemed to want our business...

Feb 2024
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VP/Other Executive

Relationship

HealthEdge innovates all the time, and they do everything to benefit their end users. There is...

Feb 2024
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VP/Other Executive

Relationship

HealthEdge has had some growing pains. When vendors grow too fast or too quickly, there are...

Feb 2024
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Director

Relationship

HealthEdge doesn't have enough time to do much of anything except bare-bones stuff, and their...

Feb 2024
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Director

Product, Value

HealthRules Payer is expensive and buggy, and it has a gigantic IT footprint with servers,...

Feb 2024
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Director

Operations, Product

HealthRules Payer is extremely configurable in a very tough market with very customized states,...

Feb 2024
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Director

Value

I could go on and on about why I wouldn't buy HealthRules Payer again. The industry is tough. The...

Feb 2024
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Director

Culture, Value

It feels like everywhere we turn, we get charged for something. The license fees cover no...

Feb 2024
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Director

Loyalty, Relationship

Hopefully our satisfaction has gone up in a year. I have a regular call with one of HealthEdge's...

Feb 2024
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VP/Other Executive

Product

From a claims processing standpoint, the product's efficiency is fantastic. That is where the...

Jan 2024
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VP/Other Executive

Loyalty, Operations

We recommend HealthRules Payer to others all the time. It is very rare that we aren't happy with the...

Jan 2024
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CTO

Loyalty, Product

We have seen HealthEdge really step up in the AI space. I think there is a lot of movement with the...

Nov 2023
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CTO

Loyalty, Product

I think that there are some core gaps that HealthEdge still needs to address. I know that HealthEdge...

Nov 2023
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CTO

Product

We recommend the system a lot. We don't have any issues with running multiple lines of business...

Nov 2023
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CTO

Loyalty, Value

The system has some core capabilities that we still have to pay for. Until that stops, I think our...

Nov 2023
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CIO

Loyalty, Relationship, Product

On the payer side, HealthEdge has worked a lot on performance. They have been very collaborative...

Oct 2023
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CIO

Relationship

HealthEdge’s general manager for the payer side left the company. That individual was really good,...

Oct 2023
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CIO

Loyalty

HealthEdge had their whole leadership team at their last conference. That conference focused on AI...

Oct 2023
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Director

Product

Some things that we do with HealthRules Payer are customized, and our business is a little complex,...

Oct 2023
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Director

Relationship

There is a lot of triage that goes on with HealthEdge where our issues bounce around a couple of...

Oct 2023
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Director

Relationship

HealthEdge suffers in the service space in some areas, and they are not a great service organization...

Oct 2023
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Director

Loyalty

We decided to go with HealthRules Payer because it wasn’t as expensive as our previous solution, and...

Oct 2023
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Director

Value

If we want something from HealthEdge, we pay them to put that thing onto their product road map, or...

Oct 2023
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Director

Culture

We are working on adding new lines of business with HealthEdge that are more standard than some...

Oct 2023
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Director

Value

We are confident in the lines of business that we have set up in HealthRules Payer. It is one of the...

Oct 2023
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VP/Other Executive

Loyalty, Relationship

HealthEdge is a good partner. They have struggled with talent loss over the last couple of years,...

Oct 2023
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COO

Product

One of HealthRules Payer’s strengths is its usability across claims, customer service, appeals and...

Sep 2023
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COO

Operations

HealthRules Payer needs to have a base training curriculum. Every health plan is different with...

Sep 2023
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COO

Operations

The configurability of HealthRules Payer is excellent. We used an implementation partner to help us...

Sep 2023
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COO

Relationship

Our HealthEdge account executive is world class. They have the right level of engagement. They...

Sep 2023
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Manager

Relationship, Value

The product is as good of a help as we could have wanted or expected. Our claims team has been...

Sep 2023
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Manager

Product

HealthRules Promote is an application that provides a way to migrate configuration between instances...

Sep 2023
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CIO

Relationship

HealthEdge delivers on their promises and is effective in helping us, but the experience is only as...

Aug 2023
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CIO

Relationship, Product, Value

HealthRules Payer does a good job in helping to automate configuration management from lower...

Aug 2023
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Manager

Relationship, Product

The HealthEdge product is pretty good, but some of the configurations within the system don’t...

Aug 2023
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Manager

Operations

HealthEdge was pretty good at initial training, and we know they have some work groups out there for...

Aug 2023
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Manager

Product

HealthRules Payer is intuitive. It is full of hyperlinks, and it is easy to navigate all of the data...

Aug 2023
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Manager

Relationship, Product

We would like the vendor to communicate any difficulties with data transfer between our...

Aug 2023
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Manager

Relationship

We would like to see HealthEdge have a clearer delineation of duties. There is some disorganization....

Aug 2023
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Manager

Product

We like the point-and-click functionality within the HealthEdge system. That makes it easy to...

Aug 2023
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Director

Relationship

It is hard to get somebody at HealthEdge on the phone. When we need the vendor, we have to be pretty...

Aug 2023
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Director

Operations

HealthEdge has nobody to do a train-the-trainer model, and they have no guidance on how to process a...

Aug 2023
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Director

Product

HealthEdge's base system is very good and really simple. One of the strengths of HealthRules Payer...

Aug 2023
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Director

Relationship

HealthEdge’s customer engagement is weak. I don't feel that they get very hands on with the users...

Aug 2023
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(0)
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Director

Relationship

HealthEdge has some issues with follow-up and closure. We brought issues to their attention, and the...

Aug 2023
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(0)
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Director

Operations

HealthEdge did not have a program where they specifically came out and trained us. Instead, we had...

Aug 2023
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