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HealthRules Payer
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User Commentary

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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
||
(0)
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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
||
(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
||
(0)
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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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(0)
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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
||
(0)
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Manager

Relationship

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

Mar 2023
||
(0)
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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
||
(0)
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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
||
(0)
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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
||
(0)
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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
||
(0)
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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
||
(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
||
(0)
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Director

Product, Value

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

Mar 2023
||
(0)
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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
||
(0)
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VP/Other Executive

Relationship, Operations

Anything would be better than what we previously had, but we feel like we have to reach out to...

Dec 2022
||
(0)
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VP/Other Executive

Relationship

The folks that we have been engaging with at HealthEdge have been fantastic so far.

Dec 2022
||
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VP/Other Executive

Culture, Product

Sometimes things were purposely glossed over in the sales presentation. The product was weak in a...

Dec 2022
||
(0)
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VP/Other Executive

Product

The quality of the product is solid; it is a hell of a lot easier to use than our previous system.

Dec 2022
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VP/Other Executive

Operations, Product

When we converted our data from our previous system to HealthRules Payer, HealthEdge's product was...

Dec 2022
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VP/Other Executive

Relationship, Operations

Infrastructure is critical with HealthEdge. We have come across server issues and capacity issues...

Dec 2022
||
(0)
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VP/Other Executive

Loyalty

HealthEdge is a great technology company. As they have gone out to the market and purchased other...

Dec 2022
||
(0)
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VP/Other Executive

Relationship

HealthEdge lacks in their professional services. They are more of a technology company, not so much...

Dec 2022
||
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VP/Other Executive

Relationship

We talk to HealthEdge often, so they are at the table. Informally, there are a lot of communications...

Dec 2022
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VP/Other Executive

Loyalty, Product

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

Relationship, Product

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

Nov 2022
||
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VP/Other Executive

Loyalty, Relationship

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

Nov 2022
||
(0)
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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
||
(0)
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CIO

Loyalty, Relationship

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

Nov 2022
||
(0)
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CIO

Product

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

Nov 2022
||
(0)
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Manager

Relationship

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

Nov 2022
||
(0)
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Manager

Relationship

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

Nov 2022
||
(0)
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Manager

Operations, Product

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

Nov 2022
||
(0)
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Manager

Product

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

Nov 2022
||
(0)
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Manager

Product

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

Nov 2022
||
(0)
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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
||
(0)
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COO

Relationship

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

Oct 2022
||
(0)
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COO

Relationship

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

Oct 2022
||
(0)
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COO

Relationship

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

Oct 2022
||
(0)
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Manager

Loyalty, Relationship

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

Oct 2022
||
(0)
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Manager

Loyalty, Product

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

Oct 2022
||
(0)
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Manager

Value

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

Oct 2022
||
(0)
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Manager

Product

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

Oct 2022
||
(0)
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Manager

Product

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

Oct 2022
||
(0)
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Manager

Loyalty, Relationship, Product

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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