BURLINGTON, Mass. - November 14, 2011 - HealthEdge®, provider of the only modern, enterprise-class software platform for healthcare payers, today announced that Neighborhood Health Plan of Rhode Island (Neighborhood) has successfully implemented the patented HealthRules product suite.  Neighborhood, the #8 ranked Medicaid health plan in America*, selected HealthEdge's products in order to enhance claim and benefit administration, improve transparency and increase operational efficiencies. HealthEdge was chosen after a comprehensive vetting process involving six leading vendors.
The requirements of today's healthcare market cannot be met with out-of-date technology and legacy systems.  Neighborhood chose HealthEdge's HealthRules product suite because it was determined to find a new system with the flexibility and scalability to respond to new opportunities available through health reform and a partner with a strong commitment to customer service.  HealthRules' real-time configurability, transparency, and interoperability will allow Neighborhood to quickly respond to market and regulatory changes, automate expensive manual processes, and continue to provide unparalleled member and provider service.
"Working with HealthEdge has been a great experience," said Mark E. Reynolds, chief executive officer for Neighborhood.  "Their ‘can-do' culture and partnership approach have been critical to our successful implementation.  The speed with which we now can adapt and the additional functionality we now have will be important as we look to serve our current and new populations. We are pleased that we not only got a great core administrative system, but also a committed partner to support us."
The HealthRules product will allow Neighborhood front-line staff to easily configure the system to meet changing demands, rather than rely on the IS department to make the changes for them. HealthRules also provides Neighborhood with new functionality that may be used to support business growth as a result of health reform and other changes in the marketplace. Further, Neighborhood has already achieved higher claims auto adjudication rates through HealthRules which will enable them to reengineer business processes and become more efficient. eighborhood Health Plan of Rhode Island has a strong reputation as a leader in the market that is committed to delivering outstanding customer service," said HealthEdge CEO Rob Gillette.  "With HealthRules in place, the organization now has the tools it needs to meet the business imperatives of the 21st century healthcare economy.  We are excited that Neighborhood is now live on HealthRules, and we are looking forward to continuing our strong partnership with them in the coming years."
About Neighborhood Health Plan of Rhode Island
Founded in 1994, Neighborhood Health Plan of Rhode Island (Neighborhood) is a not-for-profit Health Management Organization (HMO) that partners with the Community Health Centers and others improving access to care and health in Rhode Island.  Neighborhood contracts with the state of Rhode Island to administrator the RIte Care and Rhody Health Partners programs, and serves 67 percent of Rhode Island's Medicaid managed care participants.  Neighborhood is rated "Excellent" by the National Committee for Quality Assurance (NCQA) and has ranked as one of the top ten Medicaid health plans in America according to NCQA since the inception of rankings in 2004.
About HealthEdge
HealthEdge provides the only modern, enterprise-class software platform for healthcare payors. Using the patented, award-winning HealthRules software suite, health plans, health insurance companies and other payors can finally respond to new business opportunities and market changes in hours, not months or years, while drastically reducing both IT and operational costs.  Leveraging an investment of over $150 million, HealthRules is the most modern, scalable and cost-effective technology in the industry.  HealthEdge is the only choice for payors to survive and thrive in the emerging healthcare economy.  For more information, visit www.
* According to the National Committee for Quality Assurance (NCQA's 2011-2012 Health Insurance Plan Rankings - Medicaid)