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ALEXANDRIA, Va.--(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. Healthcare Payers, 2021.i

According to the Gartner report, Prospective payment integrity (PPI) solutions enable payers to proactively avoid paying claims improperly, versus paying and then chasing claims dollars. 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). They incorporate claims editing, data mining and complex clinical review, as well as advanced analytics and AI.

The Burgess Group, acquired last year by HealthEdge, offers a cloud-based platform called Burgess Source, which is the first solution to natively bring together claim payment automation with business intelligence. The platform enables payers with Medicare, Medicaid and commercial lines of business to have better relationships with providers, reduce waste and improve their financial performance. Parent company HealthEdge is a provider of the industrys leading financial, administrative and clinical platform for health insurers.

We are delighted to be recognized this way for the third consecutive year by Gartner, and even more excited about our future as part of the HealthEdge family of companies, said Ryan Mooney, Burgess Executive Vice President and General Manager. Our solution is extraordinary on its own, but can also be integrated with the industry-leading, cloud-based technologies in the claims administrative processing offered by HealthEdge, and the care management capabilities of Altruista Health. Together, these address the three most important value streams within a health plan, and this integration represents a unique value proposition in the industry.

Parent company HealthEdge has just surpassed the decade mark in being named a Sample Vendor in the Gartner report: Hype Cycle for U.S. Healthcare Payers, 2021, in the Next Generation Core Administrative Processing Solutions category.

DisclaimeriGartner, Hype Cycle for U.S. Healthcare Payers, 2021, Bryan Cole, Jeff Cribbs, Mandi Bishop, 13 July 2021. Gartner and Hype Cycle are registered trademarks of Gartner, Inc. and/or its affiliates in the U.S. and internationally and are used herein with permission. All rights reserved. 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. Gartner research publications consist of the opinions of their research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

About The Burgess GroupBurgess operates at the intersection of healthcare, finance and technology. The company helps leading American health insurers and ACOs set a new standard: Payment Accountability. The Burgess Source platform is the only solution that natively brings together up-to-date regulatory data, claims pricing and editing and real-time analytics tools. This unified approach allows clients to make payments with total confidence and make business decisions with real intelligence. The company is headquartered in Alexandria, Virginia, and online at http://www.burgessgroup.com.

About HealthEdgeHealthEdge is the health insurance industrys first digital nervous system to provide automation and seamless connectivity between all parts of a payers administrative and clinical systems. 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. Its next-generation enterprise solution suite is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. In 2020, Blackstone became the majority owner. 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. Follow HealthEdge on Twitter or LinkedIn.

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Burgess Again Named Sample Vendor for Prospective Payment Integrity Solutions in Gartner Hype Cycle for U.S. Healthcare Payers, 2021 - Business Wire