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FirstCare Health Plans Selects HealthEdge Software Suite

The HealthRules product suite includes components that handle claims, benefits administration, and business intelligence.

Abilene, Texas-based carrier FirstCare Health Plans has selected the HealthRules product suite from Burlington, Mass.-based HealthEdge.

The HealthRules suite consists of four parts, according to HealthEdge's website: HealthRules Payor, a claims and benefits administration component; HealthRules Answers, featuring business intelligence capabilities; HealthRules Portal, an access point for members, brokers, employers and providers; and HealthRules Connector, an enterprise integration layer that links the rest of the components to carriers' other systems.

FirstCare picked HealthRules after an "exhaustive, multi-year search" for new core systems in order to "address upcoming market demands, quickly adopt new health care standards like ICD-10, dramatically increase efficiency and offer our customers an even greater selection of cutting-edge products and services," CIO Arik Hill says in a statement.

"We realized several years ago that our ability to remain competitive in the rapidly changing health care market would depend on having the latest technology at our disposal," Hill adds. "The HealthRules product suite will provide us with the flexibility, power and capabilities that we will need as we continue to grow our business, and as we continue to expand our offerings to our customers.”

Nathan Golia is senior editor of Insurance & Technology. He joined the publication in 2010 as associate editor and covers all aspects of the nexus between insurance and information technology, including mobility, distribution, core systems, customer interaction, and risk ... View Full Bio

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