These technologies facilitate accurate claims processing with minimal payment leakage, addressing contracts and services, eligibility, and payment accountability along with fraud, waste and abuse (FWA). iĪccording to the Gartner report, "Prospective payment integrity (PPI) solutions enable payers to proactively avoid paying claims improperly, versus paying and then chasing claims dollars. Follow HealthEdge on Twitter or LinkedIn.ALEXANDRIA, Va., August 23, 2021-( BUSINESS WIRE)-The Burgess Group, an innovator in healthcare payment operations for more than 20 years, said today it has been named a Sample Vendor in the Prospective Payment Integrity Solutions category in the Gartner report: Hype Cycle for U.S.
HealthEdge and its portfolio of mission-critical technology assets for payers, including The Burgess Group and Altruista Health, are collectively driving a digital transformation in healthcare.
In 2020, Blackstone became the majority owner. Its next-generation enterprise solution suite is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. HealthEdge provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect everyone in the healthcare delivery cycle. HealthEdge® is the health insurance industry’s first digital nervous system to provide automation and seamless connectivity between all parts of a payer’s administrative and clinical systems.
Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose. Gartner’s research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner does not endorse any vendor, product, or service depicted in its research publications and does not advise technology users to select only those vendors with the highest ratings or other designation. and internationally and are used herein with permission. Gartner and Hype Cycle are registered trademarks of Gartner, Inc. Healthcare Payers, 2021, Bryan Cole, Jeff Cribbs, Mandi Bishop, 13 July 2021. Similarly, Burgess was named a Sample Vendor for the third consecutive year in the Gartner report for the Prospective Payment Integrity Solutions category for the Burgess Source® solution. In addition, we are maximizing the strength of our CAPS solution by integrating it with the industry’s leading cloud-based technologies in payment integrity and care management with the HealthEdge acquisition of The Burgess Group and Altruista Health in 2020.” “We are poised for growth and innovation as we advance the first-ever, next-generation integrated solution suite for the three most important value streams within health plans. “This milestone comes at an especially significant point in our evolution as an organization,” said Steve Krupa, HealthEdge Chief Executive Officer. It enables them to seamlessly and efficiently administer benefits, configure plans, manage providers and enroll participants.Īs per the Gartner report, “Next-generation core administrative processing solutions (CAPS) enable payers to manage their enrollment, premium billing, claims processing, and payment operations more nimbly and with greater flexibility than existing legacy applications.” The Gartner report also states that, “solutions must meet the following criteria: support cloud delivery models allow clients to configure policies and processing rules without IT intervention decouple modular business functions and support third-party module integrations enable value-based payment and provide preconfigured and configurable interfaces.” HealthEdge provides mission-critical HealthRules Payor® CAPS solution to healthcare payers. Healthcare Payers, 2021” i report for the 11th consecutive year.
BURLINGTON, Mass.–(BUSINESS WIRE)–HealthEdge Software said today it has been named a Sample Vendor for the Next-Generation Core Administrative Systems category in the Gartner “Hype Cycle for U.S.