HealthEdge
HealthEdge provides a Core Administrative Processing System and related software for health plans to manage claims, improve efficiency, and support digital transformation.
HealthEdge, founded in 2005 and headquartered in Burlington, Massachusetts, provides technology for the health insurance sector. The company's central offering is a Core Administrative Processing System (CAPS) designed to help health plans modernize their operations, process claims, and bring new products to market.
Its platform, the HealthRules product suite, is used by over 130 health plan customers, covering more than 110 million members across 48 U.S. states. The company's focus on digital transformation aims to help insurers evolve their business models. Technical domains include payment integrity, care management, and AI-driven business intelligence.