Burgess Listed as a Sample Vendor for Prospective Payment Integrity Solutions in Gartner’s Hype Cycle for U.S. Healthcare Payers, 2020

9.22.2020 | Burgess cited in Gartner research report entitled, "Hype Cycle for U.S. Healthcare Payers, 2020" (August 2020)

ALEXANDRIA, Va. – The Burgess Group, LLC (“Burgess”), an innovator in healthcare payment operations for more than 20 years, today announced that the company has been identified as a Sample Vendor in Gartner’s annual report: Hype Cycle for U.S. Healthcare Payers, 2020 (August 2020). Gartner identified Burgess as a Sample Vendor in the Prospective Payment Integrity Solutions category.

According to the report, “prospective payment integrity solutions enable payers to proactively avoid paying claims improperly, versus focusing on the pay-and-chase activities that define retrospective payment integrity solutions. 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). These solutions incorporate tools that include claims editing, data mining and complex clinical review, as well as advanced analytics and AI.”1

Burgess was recently acquired by HealthEdge Software, Inc.® (“HealthEdge”), a provider of the industry’s leading financial, administrative, and clinical platform for health insurers. HealthEdge has also been identified as a Sample Vendor in Gartner’s annual report: Hype Cycle for U.S. Healthcare Payers, 2020, in the Next Generation Core Administrative Processing Solutions category.

“Our company has tremendous respect for Gartner and we are thrilled to be recognized in this report for another year,” said Jared Lorinsky, Chief Strategy Officer, Burgess. “Our coming together with HealthEdge reflects our commitment to addressing the estimated $1 trillion in wasteful spending in the U.S. healthcare system and to developing best-in-class, unified solutions to improve payment integrity.”

Burgess Source® 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.

1 Gartner, Hype Cycle for U.S. Healthcare Payers, 2020, Mandi Bishop, Jeff Cribbs, Bryan Cole, 5 August 2020.

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About Burgess

Burgess 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 company’s cloud-based platform, Burgess Source, 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, VA, with an office in West Hartford, CT, and online at burgessgroup.com.

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