HealthRules Payer Commentary
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Subject Expert
Mark Allphin
Vice President of Sales
Commentary Summary
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User Commentary
Product
The product doesn’t meet all our needs, but to be fair, that is more on the payers than on the...
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Operations, Product
HealthRules Payer is a good system now. There are pros and cons to it. HealthEdge doesn’t have the...
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Loyalty, Relationship
HealthEdge wants to build AI into their suite to simplify our customer service calls and claims...
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Relationship
HealthEdge has never treated us like we are anything less than a big client. We have been treated...
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Relationship, Product
We leverage HealthRules Connector for integrations with other systems, and it allows us to automate...
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Relationship, Product
HealthEdge is certainly always looking at ways to advance, and they are very knowledgeable when it...
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Culture, Value
Typically, we bring in paid services through HealthEdge when we do larger upgrades to make sure that...
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Relationship
Sometimes, there is a lot of back and forth on our tickets, and we receive delayed responses from...
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Product, Value
HealthRules Payer is highly configurable, and it really meets our needs. We have a very high...
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Loyalty, Product
We are really interested in HealthEdge's hosted SaaS solution. The vendor doesn't currently have a...
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Loyalty
If I were starting a small, standalone health plan and were going to have a lot of complexity in...
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Relationship
A lot of things could be smoother and could integrate better, but that isn't necessarily all...
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Relationship
I don't have regular touch points with anyone at HealthEdge, but if I need them, I can reach out,...
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Relationship
Outside of whatever just comes out of the box, I wouldn't really say that HealthEdge is automating...
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Loyalty, Product
Talking about delivering new technology and actually delivering it are two different things....
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Relationship
For the most part, I don't go to the account manager anymore. I go above them to a vice president....
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Relationship
Sometimes we find an issue, and HealthEdge will tell us that another account had the same issue, and...
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Value
HealthEdge used to really peck us a lot and nickel-and-dime us. They aren't as bad as they used to...
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Relationship, Product
HealthEdge’s reporting and analytics are not that great. They have an EDW that they propagate from...
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Loyalty, Product
HealthEdge is doing a fair job of modernizing our system. The end users like it. We have some custom...
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Relationship, Product
HealthEdge doesn't support the new CMS mandate that has come out at all. The last product we were on...
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Relationship, Product
HealthEdge has a concept for the claims so that when a claim pends, it doesn't adjudicate for...
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Loyalty, Product
As a claims system, HealthRules Payer does pretty well, but that isn't what we use the system for....
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Loyalty, Operations
I would like to see HealthEdge look at a health plan ecosystem beyond claims processing and think...
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Value
HealthRules Payer was a very costly investment, but it does work as designed. The investment piece...
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Relationship
HealthEdge’s support is pretty responsive. What is going well with HealthEdge is that our account...
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Product, Value
The HealthRules Payer system is performing as expected with high accuracy in claims processing....
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Loyalty
We are moving to the cloud, so I look forward to having more recent and frequent upgrades to stay on...
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Loyalty, Product
HealthEdge has an intention to be focused on AI and automation. We do that outside of the system. We...
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Relationship
HealthEdge is way better than when we started.
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Product
HealthEdge is very strong in adjudicating claims, configuration, and benefits. The finance,...
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Relationship, Product
The vendor has inbred work baskets that we use, so those are helpful for our business teams. There...
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Loyalty
The billing piece may not be where it should be. We are using it now, but we have made the decision...
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Relationship, Value
HealthEdge seems to be focused on money. Before, they were not good. Our last release had a lot of...
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Loyalty, Product
The vendor has a data warehouse component we have asked for enhancements on, but we haven’t really...
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Relationship
The people who work for HealthEdge are supportive, collaborative, and knowledgeable.
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Product, Value
In general, HealthRules Payer is a fine solution for claims. We are frustrated when HealthEdge...
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Product
HealthRules Payer isn't totally where we would like them to be yet in terms of exceeding...
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Loyalty, Relationship
We are looking at modernizing HealthRules Payer. HealthRules Payer brings their product road map to...
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Operations
HealthEdge overcharges when it comes to implementations. The clock is always ticking. Additionally,...
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Loyalty
When it comes to modernizing our system, we have seen some pretty slides from HealthEdge, but we...
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Product
HealthRules Payer is too flexible, and the platform does some really silly things. There are certain...
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Relationship
HealthEdge has a very good user community that alerts us to problems.
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Relationship
One improvement I would like to see on the payer side would be faster turnaround times for some of...
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Product, Value
Automation within HealthRules Payer is really all built into the benefit plans, the fee schedules,...
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Relationship
Our frontline resource that we work with from HealthEdge is great at helping us when we have issues....
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Relationship
HealthEdge is a growing company, so there are opportunities for them to improve their understanding...
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Loyalty, Product
HealthEdge is still building out their core foundation. We have multiple platforms that they own,...
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Relationship, Value
HealthEdge invests in improving the product from a functionality perspective as well as a user...
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Relationship, Value
HealthRules Payer doesn't meet all of our needs. While HealthEdge is responsive, they focus more on...
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Relationship
HealthRules Payer is a really savvy, sophisticated platform and does a really good job. HealthEdge...
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Loyalty, Operations
There aren't a lot of out-of-the-box reports that we can use to better analyze our work. HealthEdge...
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Product
HealthEdge is great at being a core admin platform. The technology is phenomenal for processing...
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Value
My likelihood to recommend HealthRules Payer rates high. The solution is highly configurable. It...
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Operations, Product
HealthEdge has user notes for training. They aren't anything spectacular. Also, there aren't any AI...
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Loyalty, Product
I don't know what new technology I'm missing yet. AI is an example. It might prove to be pretty...
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Product, Value
I have been around for a long time and in this industry for decades. HealthRules Payer is the best...
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Operations
Our last upgrade was years ago, but we have a very intense implementation routine. We have built...
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Relationship
From the service end, if I have a problem, I have to write an internal ticket, and the problem is...
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