Products | XEngine
Edifecs Products
By modernizing the front-end information exchange infrastructure, Edifecs products streamline the processing and exchange of administrative, financial and clinical transactions in real-time at the edge-of-the-enterprise, thereby helping healthcare organizations drive down administrative costs and achieve regulatory compliance. Edifecs products extend the value of middleware solutions and electronic data interchange (EDI) tools with support for healthcare-specific processes such as enrollment, claim and payment management.
Core Products
Edifecs Core Products are an integrated suite of products that provides comprehensive capabilities for every step in the transaction processing lifecycle.
Edifecs Transaction Management provides a secure end-to-end view of the healthcare transaction lifecycle to internal users and trading partners to enable better business decision-making, monitoring of performance against internal and external SLAs (Service Level Agreements), increasing claims first-pass rates, and improving delivery of customer support.
Edifecs XEngine is a comprehensive message processing system that delivers unparalleled performance and ensures operational integrity of information exchange with trading partners. XEngine provides a rich set of capabilities such as validation, splitting, routing, aggregation, enrichment of transactions and translation between multiple standards.
Edifecs Ramp Management provides a branded, self-service portal for onboarding trading partners that reduces the resources, time and cost needed to integrate partners, while enhancing partner support and reducing the risk of errors in production.
Edifecs SpecBuilder is an integrated and intuitive design-time tool for business and EDI analysts that simplifies, reduces errors in and accelerates the design phase of healthcare transaction exchange.
Edifecs Test Management enables health plans to easily create, edit and manage test data and results.
Business Applications
Edifecs Business Applications are pre-packaged healthcare-specific applications that leverage the power of Edifecs Core Products and provide complete processing capabilities, framework components, visibility and reporting tools for business operations such as enrollment, claim and payment processing.
Enrollment Management
Edifecs Enrollment Management allows health plans to receive and automatically process enrollment updates in the front-end. Updates can be processed in a variety of formats and submission methods from employers and brokers. This includes comparison of full-files from employers with internal membership systems to determine updates. Enrollment Management streamlines processing of enrollment updates, reduces enrollment-related errors and simplifies enrollment audits.
Claim Management
Edifecs Claim Management provides business rules and processes to improve the processing, routing, tracking and quality of claim submissions from providers. At the front-end, it identifies claim format and business rule errors and initiates corrective action so that providers can correct errors with a self-service portal before claims enter adjudication systems. It manages routing of claims to internal or external systems within the front-end. If also provides a single channel for communicating claim status, errors and requests for additional information with providers.