HealthEdge Source™ Editing is payment integrity editing software that combines revolutionary technology with best-of-breed content and is uniquely flexible to fit anywhere within a payer’s workflow for a customized, agile approach. HealthEdge Source Editing is designed to deliver accurate, transparent, comprehensive claims payments upstream in the adjudication process and enable payment integrity transformation for your business.

Features

Editing Content

Our content libraries include support for government, clinical, billing and validation edits to handle complex policies automatically across all LOBs.

Cloud-Based

As a cloud-based solution, HealthEdge Source was designed to automatically deliver IT infrastructure and content updates every two weeks - reducing IT lift organization-wide.

History-Enabled

Our history-enabled editing capability enables comprehensive and reliable adjudication of claims.

Business Rules Flexibility

Our user-friendly UI empowers payer teams to build and manage their provider contracts by line of business or any other common group that fits organizational needs.

Edit Exceptions

Easily override or make exceptions to existing edits to readily fit your business needs.

Audit Support

Our Advanced Audit Trail tracks all edits and prices and provides supporting documentation, including date-time stamped rules for comprehensive assistance with provider, security and compliance inquiries.

Integrated Third-Party Edit Libraries

Complement our native content with additional third-party libraries – all within a single interface for increased speed and accuracy.

Integrated Advanced Analytics

Enhanced transparency into business operations for improved business intelligence and informed decision-making.