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Burgess Again Named Sample Vendor for Prospective Payment Integrity Solutions in Gartner Hype Cycle

Burgess Again Named Sample Vendor for Prospective Payment Integrity Solutions in Gartner Hype Cycle

The Burgess Group, an innovator in healthcare payment operations for more than 20 years, said 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

“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”

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.

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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 industry’s 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.”

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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.

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