HealthRules Payer Commentary
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Subject Expert
Boyd Stewart
VP of Payer/Provider Collaboration
Commentary Summary
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User Commentary
Relationship, Product
In the last year, the vendor created a known-issue spreadsheet that we can go out and download. I...
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Value
From a claims processing perspective, we are running a high percentage automatic adjudication rate,...
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Relationship, Product
The vendor seems a little behind on how fast they get any of the new technology. There is no AI in...
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Product
We really haven't had significant downtime with the system. It has been reliable in that regard. The...
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Loyalty, Product
The functionality we have is different than all of the functionality that now exists, and that is...
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Relationship, Operations
The vendor's people are always willing to get on the phone regardless of their level. They do that...
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Loyalty
I would buy this solution again. One vendor has come a long way since we got HealthRules Payer, so...
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Operations
In terms of implementation services, we can subscribe to a white-glove service, or we can do things...
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Product
The product doesn't always integrate well. It integrates with our authorization module, our EDW, and...
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Operations, Value
The vendor doesn't train us on anything. Originally, we bought some of their training packages, and...
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Culture, Value
The vendor avoids charging for every little thing as long as we have a contract. If we don't have a...
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Relationship, Operations
HealthEdge struggles to keep their promises. They tend to focus on bigger fish. We are a small fish,...
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Value
We have to give the vendor a little credit in terms of technology. Since we went live, there have...
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Relationship
The vendor's support has gotten better. We don't have the spreadsheets of things that haven't been...
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Value
If we were to recommend the solution to somebody, I would likely tell that person right off the bat...
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Value
HealthEdge, over the long haul, has avoided charging us for every little thing. However, their...
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Relationship
For the most part, HealthEdge has been a very good vendor. Their support is really good, and we have...
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Product, Value
We have a really high automatic adjudication rate. That has allowed us to automate the bulk of our...
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Product, Value
HealthRules Payer is an excellent system. I have worked on other systems, and HealthRules Payer is...
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Product
The system is really good, but there are some things in it that are lacking, like some workflow...
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Relationship
HealthEdge has an opportunity to share upgrade lessons learned across their client base. When a plan...
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Relationship
The ongoing operations and support from HealthEdge have improved significantly, along with the...
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Culture, Relationship
I really like the HealthRules Payer system, but HealthEdge could do a better job by listening to...
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Operations
HealthEdge needs a program that has the right people helping to deliver new functionality for new...
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Product
The HealthRules Payer system being a real-time system is great. We know the end result of a claim,...
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Operations, Product
HealthRules Payer is a really good system, but we could have been much further along if everything...
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Loyalty, Product
HealthRules Payer is a core processing system but not a billing system, so we have had to go to...
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Relationship
We have had an excellent hands-on experience with the people at HealthEdge. We meet with them...
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Loyalty
We have seen significant improvement over the last year in the proactiveness of HealthEdge. Their...
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Loyalty, Relationship
The executives at HealthEdge have a vision around AI, and they are mandating that all their leaders...
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Operations, Product
We haven't had any problems with HealthRules Payer upgrades. The solution is extremely stable with...
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Product
I like the familiarity with HealthRules Payer. The configurability is nice, and so is the ability to...
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Product
HealthRules Payer doesn’t meet all our needs, and part of this is our fault. The way that we do...
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Product
We haven't really adopted additional functionality in HealthRules Payer, but when we do have...
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Product
HealthEdge has done a good job of improving the quality of their products, but we get into...
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Relationship
We are working on getting upgrades, and HealthEdge is working with us as a customer to really...
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Relationship
I'm able to get anything I need with my account team with HealthEdge. I can call them on their cell...
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Product, Value
We are experiencing a high automatic adjudication rate with HealthRules Payer. With the way the...
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Relationship
HealthEdge is still a relatively young company, and they have been doing a lot of acquisitions. As...
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Relationship
HealthEdge is getting better at being proactive. We have a really good day-to-day resource that we...
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Relationship, Product
The front-end users love HealthRules Payer; it is easy to configure, and the functionality is great....
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Product
The inherent core of HealthRules Payer is automation. I wouldn't say it is AI. The system is a...
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Relationship
HealthEdge's customer support is inconsistent. If we can get the right people, they will kill it. If...
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Value
HealthEdge is better than most at not nickel-and-diming, but there are still times when they do. I...
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Product
When it comes to the system, HealthEdge is far ahead of anyone else in terms of intuitiveness,...
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Operations, Product
I usually tell my people to just log into the system and try a transaction. They can do 70%–80% of...
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Relationship, Product
We have been working with HealthEdge on scorecards and results. The system shows the metrics around...
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Operations
We don't do a lot of training with HealthEdge, so we aren't utilizing their training services, but...
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Relationship, Operations
We have had very successful implementations with HealthRules Payer. We have had some bumps in the...
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Value
The cost of HealthRules Payer is fair with market value. Naturally, HealthEdge is a for-profit...
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Loyalty, Product
I haven't gone to RFP. I inherited HealthRules Payer, and there are other systems out there. We are...
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Product
HealthRules Payer has an outdated UI. It is a little cluttered. The vendor could definitely take...
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Loyalty
HealthRules Payer is clearly a superior technology to legacy technologies. Moving to HealthRules...
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Operations
Implementations are difficult and costly. That is a drawback. However, we are live now, and we are...
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Relationship, Product, Value
The system is very configurable, and the vendor is supportive of us reaching our targeted automatic...
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Relationship
HealthEdge's work with APIs and interoperability is strong. HealthEdge has supported us in...
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Operations, Value
It would have been cool to do this survey after meeting with HealthEdge because then I would know...
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Relationship
We have invested in other HealthEdge products, like Source. The vendor is really strong with clean...
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Relationship
HealthEdge doesn’t do very well at being proactive on the service side. We constantly have to...
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Value
HealthEdge is fair about charging, and there are no significant charges as we have seen with other vendors....
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Product
HealthRules Payer is a pretty good product for a midsize payer plan. It is pretty intuitive. We...
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Operations
Implementations and upgrades are sometimes part of HealthEdge’s downfall. Sometimes in their...
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Relationship, Product
Interoperability is what HealthRules Payer lacks. The vendor has an API connector, but it is...
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Product, Value
The operational efficiency improvements from HealthRules Payer really come in terms of the...
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Loyalty, Product, Value
There are files that are required for the transparency in coverage rule, and they are...
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Relationship
HealthEdge has really stepped up their executive involvement. However, I think everything comes down...
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Relationship, Operations
One area where we face challenges with HealthEdge is communication. HealthEdge created a new...
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Product
HealthEdge’s product is decent, but we had a bad upgrade that had a lot of issues, and that reduced...
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Product, Value
HealthRules Payer doesn't have a robust reporting system. We had to take the reporting offline. We...
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Product
HealthEdge is good on the Medicare commercial side. Medicaid is a bit of a weak area, and we had to...
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Value
HealthRules Payer is an expensive system that takes a lot to support and run. On the back end, it is...
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Operations
Regarding implementations, HealthEdge misses the mark in terms of quality and timeliness. Sometimes,...
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Product
Ease of use is probably one of HealthEdge’s strengths. HealthRules Payer is a modern system that...
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Relationship
HealthEdge is reactive. They could improve their testing processes and general promptness in...
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Loyalty
Sometimes, the vendor's plans get squashed. For example, HealthEdge said they were going to have a...
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Relationship
We have been with HealthEdge a long time, so the support might be a little bit better We have been...
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Loyalty
HealthEdge has a product called Care-Payer. We are upgrading our other HealthEdge products to make...
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Product, Value
We can configure our stuff into a ton of manual processes with HealthRules Payer, and HealthEdge...
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Product
Before we moved to HealthRules Payer, I couldn't break a certain number on the adjudication system...
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Loyalty, Value
We looked at one of HealthEdge's competitors. At that time, HealthEdge seemed to want our business...
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Relationship
HealthEdge innovates all the time, and they do everything to benefit their end users. There is...
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Relationship
HealthEdge has had some growing pains. When vendors grow too fast or too quickly, there are...
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Relationship
HealthEdge doesn't have enough time to do much of anything except bare-bones stuff, and their...
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Product, Value
HealthRules Payer is expensive and buggy, and it has a gigantic IT footprint with servers,...
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Operations, Product
HealthRules Payer is extremely configurable in a very tough market with very customized states,...
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Value
I could go on and on about why I wouldn't buy HealthRules Payer again. The industry is tough. The...
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Culture, Value
It feels like everywhere we turn, we get charged for something. The license fees cover no...
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Loyalty, Relationship
Hopefully our satisfaction has gone up in a year. I have a regular call with one of HealthEdge's...
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Loyalty, Product
We have seen HealthEdge really step up in the AI space. I think there is a lot of movement with the...
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Loyalty, Product
I think that there are some core gaps that HealthEdge still needs to address. I know that HealthEdge...
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Product
We recommend the system a lot. We don't have any issues with running multiple lines of business...
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Loyalty, Value
The system has some core capabilities that we still have to pay for. Until that stops, I think our...
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Loyalty, Relationship, Product
On the payer side, HealthEdge has worked a lot on performance. They have been very collaborative...
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Relationship
HealthEdge’s general manager for the payer side left the company. That individual was really good,...
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Loyalty
HealthEdge had their whole leadership team at their last conference. That conference focused on AI...
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Product
Some things that we do with HealthRules Payer are customized, and our business is a little complex,...
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Relationship
There is a lot of triage that goes on with HealthEdge where our issues bounce around a couple of...
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Relationship
HealthEdge suffers in the service space in some areas, and they are not a great service organization...
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Loyalty
We decided to go with HealthRules Payer because it wasn’t as expensive as our previous solution, and...
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Value
If we want something from HealthEdge, we pay them to put that thing onto their product road map, or...
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Culture
We are working on adding new lines of business with HealthEdge that are more standard than some...
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Value
We are confident in the lines of business that we have set up in HealthRules Payer. It is one of the...
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