HealthRules Payer Commentary
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Boyd Stewart
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KLAS Research Director - Boyd Stewart
 
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User Commentary

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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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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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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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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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CIO

Loyalty, Relationship, Product

We rely on HealthRules Payer for our machine-readable files. We are not the only client struggling,...

May 2023
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CIO

Product

Right now, we are struggling with a couple of things. We continue to struggle with system...

May 2023
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CIO

Product

HealthRules Payer breaks between upgrades. The vendor has consolidated the number of upgrades they...

May 2023
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CIO

Relationship

A yellow flag we are seeing is that HealthEdge’s senior leadership executive turnover feels high....

May 2023
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CIO

Relationship

I have a routine call with our contact people from HealthEdge, and they are helpful. That is great....

May 2023
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VP/Other Executive

Relationship

Some of HealthEdge’s biggest strengths are their willingness to help when there are urgent needs and...

May 2023
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VP/Other Executive

Relationship, Product

We have struggled with HealthEdge’s code updates. They don't have a good process for those, and we...

May 2023
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VP/Other Executive

Operations, Value

HealthEdge has robust training that they charge a lot of money for.

May 2023
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CMO

Operations, Product

We are trying to improve the overall member experience with our technology. We are trying to...

May 2023
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CMO

Operations, Value

The way the system functions has made the end users’ work easier. We have gone from old green...

May 2023
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CIO

Relationship

Working with the vendor’s support people is challenging. I have to escalate more than I should.

May 2023
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CIO

Culture

HealthEdge oversold us a bit. Their offering wasn't material enough, and some components weren’t...

May 2023
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VP/Other Executive

Relationship

HealthEdge is getting better at working with us. We have regular meetings with our technical account...

May 2023
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VP/Other Executive

Relationship

HealthEdge could improve their turnaround times on service requests. They are only working on our...

May 2023
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CEO/President

Product

Some of the functionalities in HealthRules Payer are just plain awful. For example, the solution...

May 2023
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CEO/President

Product

Some of the functionalities in HealthRules Payer are rock stars. For example, the configuration and...

May 2023
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CEO/President

Relationship, Product

In order for the external file transfers to work when setting up HealthRules Payer, we really need...

May 2023
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CEO/President

Product

My biggest concern with upgrades in HealthRules Payer is that the upgrades will break the interfaces...

May 2023
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CEO/President

Relationship

I don’t get great feedback on HealthEdge’s support. I would like the vendor to do more engagement...

May 2023
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CEO/President

Relationship

HealthEdge’s support people don't have to necessarily go up the chain of command to solve problems....

May 2023
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CEO/President

Loyalty

We decided to go with HealthEdge because we looked at them years ago and were very intrigued by the...

May 2023
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VP/Other Executive

Operations

We had some hiccups in our implementation. Part of that was due to how the project was structured...

May 2023
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VP/Other Executive

Relationship

HealthEdge is still trying to determine what the best model looks like. They shift resources or...

May 2023
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VP/Other Executive

Relationship

We would tell a friend or peer looking at HealthEdge that both organizations need to understand the...

May 2023
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VP/Other Executive

Culture, Product

There are things HealthRules Payer doesn’t do. But overall, the platform has worked as promoted....

May 2023
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VP/Other Executive

Relationship

HealthEdge is extremely open, and they reach out to get as much feedback as they can from their...

May 2023
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VP/Other Executive

Loyalty, Product

We have HealthRules Payer, and we have a couple of other products out there. There are no standard...

May 2023
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VP/Other Executive

Relationship

The vendor’s responsiveness is a significant pain point for us. Running a claims payable cycle can...

May 2023
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VP/Other Executive

Loyalty, Relationship

We understand that it is going to take some time for HealthEdge to develop products they purchase,...

May 2023
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VP/Other Executive

Loyalty, Product

Overall, things are going very well with HealthEdge. Their tool definitely meets the needs of our...

May 2023
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VP/Other Executive

Relationship, Product

There are always different types of functionalities that we would like to see. One of those...

May 2023
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VP/Other Executive

Loyalty

We can do everything that we need to do in HealthRules Payer, and we have a lot of other options....

Apr 2023
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VP/Other Executive

Relationship, Product

HealthEdge can pull things into the product that roll out across the platform from somewhere else....

Apr 2023
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VP/Other Executive

Relationship

HealthEdge has come through on some things, but there are definitely other things that they haven't...

Apr 2023
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(0)
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VP/Other Executive

Product

There are some areas in the system where we have been really successful, like the EDI area. We went...

Apr 2023
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VP/Other Executive

Product, Value

I would buy the system again, especially when it comes to the system's core. Some of my hesitation...

Apr 2023
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VP/Other Executive

Value

HealthEdge tries to sell us on technical-only upgrades, and we have found that that doesn't work for...

Mar 2023
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VP/Other Executive

Product, Value

When it comes to claims processing and payment, HealthRules Payer has helped with our automatic...

Mar 2023
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VP/Other Executive

Operations

We had our struggles with upgrading HealthRules Payer, and we paid for resources so that we wouldn’t...

Mar 2023
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VP/Other Executive

Loyalty, Product

We want to integrate HealthRules Payer with a non-EMR solution, and we haven't been able to do that...

Mar 2023
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VP/Other Executive

Relationship

We have a really great technical account manager with HealthEdge.

Mar 2023
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VP/Other Executive

Relationship

HealthEdge’s support is probably the biggest pain point for me. We have to prioritize a very small...

Mar 2023
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VP/Other Executive

Product

The platform's configuration, adaptability, and flexibility have benefited our business. The vendor...

Mar 2023
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VP/Other Executive

Culture

The vendor has some areas that don't seem to be maturing. One of those areas would be their...

Mar 2023
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VP/Other Executive

Relationship, Operations, Product

We struggle when the system has issues. We have found that the vendor's turnaround time isn't as...

Mar 2023
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VP/Other Executive

Culture, Relationship

When the vendor specifically says that they have a deliverable for us, that is a promise that they...

Mar 2023
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Manager

Loyalty, Product, Value

Overall, HealthRules Payer performs very well. Part of the reason our health plan is so highly rated...

Mar 2023
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Manager

Relationship

Before the pandemic, the executive involvement from HealthEdge was very high. However, with...

Mar 2023
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Manager

Product

HealthRules Payer’s ease of use is getting better, and its performance is an improvement over our...

Mar 2023
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Manager

Product, Value

HealthEdge needs to improve their system’s performance. We have many employees that are in...

Mar 2023
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Manager

Loyalty, Relationship

We have a direct connection to HealthEdge through our account executive, and that relationship works...

Mar 2023
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Manager

Product

Every year, we do a major upgrade of HealthRules Payer, and every year, something breaks and there...

Mar 2023
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Director

Value

HealthRules Payer does a good job with claims processing and benefit configuration. However, it is...

Mar 2023
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Director

Loyalty

I am not overly excited about where the company is headed based on their life cycle. I think that...

Mar 2023
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Director

Relationship

I love working with the people at HealthEdge. The vendor's people are great, but they aren't able to...

Mar 2023
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Director

Culture, Loyalty, Product

When the product was explained to our senior leaders, it was explained as a complete solution with...

Mar 2023
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(0)
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Director

Culture

HealthEdge is a consumer of data instead of a source of truth. We found that out as we got into the...

Mar 2023
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Director

Product, Value

The product's strength is its claims adjudication. Its automatic adjudication abilities are pretty...

Mar 2023
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Director

Product

HealthRules Payer is so complex at times that it presents the possibility of bugs. The vendor has a...

Mar 2023
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