HealthEdge Source™ Medicare Reimbursement makes accuracy easy by delivering, managing and maintaining accurate and compliant CMS pricing data so health plans don’t have to. Our solution is uniquely designed to integrate policy edits, pricing algorithms, and rate schedules and process them in parallel to improve accuracy and automation. Our depth of content includes all provider types and settings, eliminating the need to piece together multiple data sources so you can pay claims accurately, quickly and comprehensively – the first time.

Features

Medicare Content

HealthEdge Source subject matter experts research, develop and maintain content libraries that include payment policies across a wide range of facility and provider types to remove the need for multiple vendor solutions.

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.

Parallel Processing

HealthEdge Source offers integrated claims processing in parallel with policy edits, pricing algorithms, and rate schedules covering all Medicare markets in the United States for comprehensive reimbursement - enabling faster processing of claims with a single API call.

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.

CMS Reference Tool

Our CMS data reference tool provides a source of truth for all payment policies and edits with comprehensive policy explanation.