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features
design
support

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Description

HealthRules® Payer represents a cutting-edge core administrative processing system that offers transformative features for health plans across various types and sizes. For over a decade, health plans utilizing HealthRules Payer have effectively capitalized on market opportunities, maintaining a competitive edge. What sets HealthRules Payer apart from other core administrative solutions is its innovative application of the patented HealthRules Language™, which resembles English and introduces a groundbreaking methodology for configuration, claims management, and information transparency. This system empowers health plans by enabling them to expand, innovate, and outperform their peers more effectively than any other core system available today. As a result, HealthRules Payer not only streamlines operations but also fosters a culture of agility and responsiveness within health organizations.

Description

As a company that emphasizes value-driven healthcare, effective communication through a versatile and scalable platform is essential for your success. NaviNet Open stands out as one of the premier collaboration platforms in the United States, enhancing engagement among providers and producing reliable, actionable insights throughout the healthcare delivery process. This secure multi-payer system not only improves communication but also boosts operational efficiency, reduces expenses, and heightens provider satisfaction. It enables real-time exchanges of crucial administrative, financial, and clinical data between payers and providers. For NantHealth, prioritizing security is paramount. Our adherence to HIPAA regulations, coupled with a steadfast commitment to our core values, has earned us EHNAC HNAP accreditation since 2006. Additionally, NaviNet Open holds HITRUST certification, demonstrating compliance with critical regulations and industry standards. This platform effectively mitigates risks associated with third-party privacy, security, and compliance, ensuring a robust framework for all users. Such dedication to security and efficiency fosters an environment of trust and collaboration in the healthcare ecosystem.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

Cohere Unify

Integrations

Cohere Unify

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

HealthEdge Software

Website

www.healthedge.com

Vendor Details

Company Name

NantHealth

Country

United States

Website

nanthealth.com/payers/navinet-open/

Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Product Features

Hospital Management

Accounting Integration
Appointment Management
Appointment Scheduling
Bed Management
Billing & Invoicing
Claims Management
In-Patient Management
Inventory Management
Medical Billing
Out-Patient Management
Patient Records Management
Physician Management
Policy Management
Revenue Management

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