HealthRules Payer
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Subject Expert
Joe VanDeGraaff
Research Director
KLAS Research Director - Joe VanDeGraaff
 
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User Commentary

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Director

Implementation and Training

We had a really smooth go-live with HealthRules Payer. I would call the go-live a success. The...

Dec 2022
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VP/Other Executive

Service and Support

One of the areas where we are highly anticipating some change is the integration between the medical...

Nov 2022
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VP/Other Executive

Service and Support

From a support perspective, HealthRules Payor could use some improvement. The vendor uses a...

Nov 2022
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VP/Other Executive

Relationship

When we have meetings with HealthEdge and look at road maps, the vendor is absolutely driving toward...

Nov 2022
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VP/Other Executive

Relationship

When we were a new client and HealthEdge was growing, we had a lot of involvement from their...

Nov 2022
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CIO

Relationship

HealthEdge stands out as the one vendor we would want to expand the business relationship with. When...

Nov 2022
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CIO

Technology

We have had some challenges with HealthEdge. Going into our last upgrade, the upgrade looked really...

Nov 2022
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Manager

Service and Support

There are different support teams with HealthEdge; they have an A team all the way down to a G team,...

Nov 2022
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Manager

Other Observations & Comments

Ultimately, I see HealthEdge's aggressive growth as a really good thing. Part of the reason they...

Nov 2022
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Manager

Lessons Learned

I would tell a peer that they should get a certain tool that moves and manages the HealthRules Payor...

Nov 2022
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Manager

Technology

I like HealthRules Payor a lot better than our previous claims solutions. HealthRules Payor is...

Nov 2022
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Manager

Functionality and Upgrades

HealthRules Payor can handle all of our different lines of business, but there is some external...

Nov 2022
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Manager

Relationship

HealthEdge has an A team that supports the tool, and we can submit tickets if we have any bugs or...

Nov 2022
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CMO

Implementation and Training

HealthEdge didn't do our implementation, so we were left to sort out problems with the firm that did...

Oct 2022
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COO

Service and Support

I am not impressed with HealthEdge's client relationships. There were a few times when we needed to...

Oct 2022
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COO

Lessons Learned

I would suggest to somebody interested in HealthEdge that they work with a partner who uses...

Oct 2022
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COO

Interfacing and Integration

HealthEdge made an integration with another solution very hard to complete because some information...

Oct 2022
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Manager

Future Outlook

We need better support for our government programs. Getting onto the programs has taken a while, but...

Oct 2022
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Manager

Technology

We like the natural language configuration. The solution doesn't try to do everything for a plan....

Oct 2022
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Manager

ROI / Cost (care and feeding)

The vendor does charge for things, but they can sometimes do things without charging us, so if they...

Oct 2022
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Manager

Interfacing and Integration

HealthRules Payor is modern and is based on services. The system enables us to keep up with...

Oct 2022
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Manager

Other Observations & Comments

With a recent upgrade, there was an integration feature with another product that we had to wait on...

Oct 2022
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Manager

Relationship

We are working on outside pieces of the solution, but it is working as we believe it should. We just...

Oct 2022
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VP/Other Executive

Interfacing and Integration

The sticking point for us with HealthEdge continues to be the integration between GuidingCare and...

Sep 2022
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VP/Other Executive

ROI / Cost (care and feeding)

I don't think the vendor avoids charging for every little thing. They have come up with some...

Sep 2022
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VP/Other Executive

Functionality and Upgrades

There are still gaps in the product in terms of things like workflow and billing capabilities.

Sep 2022
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VP/Other Executive

Service and Support

The vendor’s support model is challenging. Trying to get to the right people to solve the problem or...

Sep 2022
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VP/Other Executive

Relationship

I am very satisfied with our current account manager, how we are getting to things on the vendor's...

Sep 2022
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VP/Other Executive

ROI / Cost (care and feeding)

The system drives outcomes for us very well. We have a great implementation partner, and the vendor...

Sep 2022
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VP/Other Executive

Functionality and Upgrades

I love HealthEdge, and I love HealthRules Payor. HealthRules Payor is a high-quality product. Its...

Sep 2022
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VP/Other Executive

Sales and Contracting

When organizations buy HealthRules Payor, they buy the product, but that cost doesn't include the...

Sep 2022
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VP/Other Executive

Lessons Learned

I hope that we will be able to connect more with the vendor's road map and the work that the vendor...

Sep 2022
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VP/Other Executive

Other Observations & Comments

We have had to escalate some key things that we needed to implement with some of our releases. Once...

Sep 2022
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VP/Other Executive

Functionality and Upgrades

The vendor has promised capabilities that haven't come to fruition. The vendor sometimes doesn’t...

Sep 2022
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VP/Other Executive

Functionality and Upgrades

We have seen some improvement on the HealthRules Payor side in terms of the quality of the releases....

Sep 2022
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VP/Other Executive

Lessons Learned

The system is pretty straightforward to implement and operate. However, with Medicare and Medicaid,...

Sep 2022
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VP/Other Executive

Relationship

HealthEdge is at the forefront of things when it comes to staying current with the direction that...

Sep 2022
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VP/Other Executive

Lessons Learned

We are really focused on automation. The system can automatically adjudicate some claims, but there...

Sep 2022
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VP/Other Executive

Lessons Learned

I am interested in learning a lot more about HealthEdge's value-based payment road map. I haven't...

Sep 2022
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VP/Other Executive

Relationship

HealthEdge's executive involvement is spotty, and it depends on the client. There is one individual...

Sep 2022
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VP/Other Executive

ROI / Cost (care and feeding)

I think that there are a few components to the product's value. The first is that HealthEdge needs...

Sep 2022
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COO

Service and Support

HealthEdge has resource constraints, and we have seen that issue with all of our vendors. HealthEdge...

Sep 2022
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COO

Relationship

HealthEdge has an individual on their product development team that does a really good job of...

Sep 2022
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Director

Implementation and Training

With our last upgrade, we identified several bugs during our testing. The vendor had difficulties...

Sep 2022
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Director

Service and Support

The support for the platform is far superior to the support we get from HealthEdge for other products....

Sep 2022
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Director

Functionality and Upgrades

The vendor has kept their promises in terms of what we have utilized the product for. The product...

Sep 2022
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COO

Lessons Learned

I would tell a peer considering the product that they will definitely need fewer staff members on...

Sep 2022
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COO

Relationship

HealthEdge’s implementation and agile services teams are very engaged. There has been very little...

Sep 2022
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Director

Functionality and Upgrades

I don't think HealthRules Payor is very user friendly. There are other vendors out there who really...

Sep 2022
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CIO

Interfacing and Integration

I just really think the vendor needs to improve the turnkey integrations. The vendor should make the...

Sep 2022
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COO

Functionality and Upgrades

HealthRules Payor is a great product. The system is very configurable, and we experience a high...

Sep 2022
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CIO

Sales and Contracting

We had some significant misses from the presale process to the actual implementation, so I would say...

Sep 2022
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CIO

Future Outlook

I am not sure my satisfaction with HealthRules Payor will change, but I could see it improving. We...

Sep 2022
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CIO

Service and Support

The vendor's professional service has some quirks, but the vendor needs to focus on being proactive....

Sep 2022
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CIO

ROI / Cost (care and feeding)

One of the big selling points for us for the product was the configuration over programmatically...

Sep 2022
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COO

Functionality and Upgrades

The out-of-the-box reporting is lacking, but I am not sure whether that is part of HealthEdge’s...

Sep 2022
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COO

Service and Support

HealthEdge has made a lot of improvements in their structure and their support. We have regular...

Sep 2022
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COO

Functionality and Upgrades

We have been able to do some integration with custom-built apps, but we really haven't tried to do a...

Sep 2022
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COO

Technology

One of the challenges of being an early adopter of a system is that we had to build a lot of custom...

Sep 2022
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COO

Relationship

HealthEdge is improving their upgrade process, and they are getting better. They wanted us to take...

Sep 2022
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COO

Relationship

HealthEdge keeps their promises and is transparent with their customers. If things aren't going to...

Sep 2022
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COO

Relationship

HealthEdge is still constrained by resources. We paid for a certain number of hours of work, but the...

Sep 2022
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COO

Relationship

HealthEdge has done training before, but by the time they got the training put together, it wasn't...

Sep 2022
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CMO

Relationship

We encountered numerous problems before and after we turned the product on, but only a small...

Sep 2022
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CMO

Lessons Learned

We were hoping that the product would be our first step in creating a foundation to improve our...

Sep 2022
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CIO

Functionality and Upgrades

HealthRules Payor has been an incredibly good platform for us, and HealthEdge has scaled well as we...

Feb 2022
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VP/Other Executive

Interfacing and Integration

What we would like to see, now that the products from HealthEdge and Altruista Health are all...

Feb 2022
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VP/Other Executive

Functionality and Upgrades

Overall, the product is doing everything the vendor said it was going to do, and we enjoy it. The...

Feb 2022
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VP/Other Executive

Service and Support

We run into issues with turnaround times with HealthEdge support. When things do get fixed, it is...

Feb 2022
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VP/Other Executive

Technology

We are discovering that the product is slow. There are some lags and some delays in our production...

Feb 2022
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VP/Other Executive

Relationship

We used to have a lot more executive involvement with the upper echelons at HealthEdge. We don't as...

Feb 2022
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Manager

Relationship

HealthEdge does charge us for producing correspondence. We are actually trying to do some custom...

Dec 2021
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Manager

Functionality and Upgrades

There were some capabilities that HealthEdge said the platform could do that the system doesn't do....

Dec 2021
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Manager

Technology

HealthEdge’s response time is fast, but their delivery can be months out. HealthEdge does have a...

Dec 2021
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Director

Future Outlook

We plan to use HealthRules Payor for a long time. The vendor continues to make strides to improve...

Dec 2021
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Director

Relationship

HealthEdge is very transparent with us when we are looking at configuration requirements or trying...

Dec 2021
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Director

Functionality and Upgrades

We have had some growth in our organization, and the solution has definitely helped us scale. It...

Dec 2021
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Director

Functionality and Upgrades

The product has some functionality issues that we are a little frustrated with. The fixes for those...

Dec 2021
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Director

Functionality and Upgrades

HealthRules Payor is a very functional system. We use it to house our benefits and contracts, and we...

Dec 2021
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Director

Other Observations & Comments

HealthRules Payor is more advanced than another one of the vendor's products. Our ROI from...

Dec 2021
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Director

Service and Support

We have had to get our executives involved to push things to a higher level with the vendor's...

Dec 2021
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Director

Other Observations & Comments

The solution has claims, benefit, and pricing-integration platforms. If someone were looking for...

Dec 2021
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