Trust all your partner interactions to Smart Trading

A one-stop solution for digital health information interoperability underpinning healthcare partnerships.

Smart Trading

Powers integration and interoperability among partnering healthcare entities. By consolidating all transaction support into one platform, Edifecs Smart Trading dramatically reduces both IT infrastructure and administrative costs.

Digital Health Information Interoperability

At the intersection of consumerism in healthcare, value-based reimbursement and the need to use population health management to improve care is the need for digital interoperability. Achieving digital interoperability requires understanding intent – data interoperability. Actualizing intent in a collaboration between partners requires process interoperability.

Consolidate information exchange for all your partners in our proven integration engine. Use Smart Trading to deliver the digitized data necessary for value-based reimbursement, population health management, consumer programs and administrative simplification.

Value Proposition

$0.60 - $0.75 PMPY

Reduce Administrative Costs

Reduce claim pre-processing costs

Reduce manual adjudication

Reduce partner onboarding costs

Reduce EDI and clinical transaction costs

$0.75 - $1.25 PMPY

Reduce IT TCO

Consolidate administrative and clinical trading infrastructure

Reduce the costs of change through configuration

Reduce the costs of change through configuration

These values are based on industry benchmarks for a regional health plan with 1.5 to 2 million members.
Actual numbers will vary based on the need to onboard/manage trading partners, claim volume and EDI infrastructure in use.

 
  • CS

    Case Study

    Voice of Customer

    "Engaging an experienced partner such as Edifecs, enabled us to gain insights and define action items to address concerns with claims and enrollment intake processes. We received a detailed guide to improve quality, service and costs that fit the parameters of our current IT landscape and business goals."

    - Senior Claims Processing Leader, Regional Health Plan

  • DS

    Data Sheet

    Voice of Customer

    "The Edifecs platform provides BCBSVT trading partners and groups with a 'self-service' website to validate their EDI files against HIPAA standards as well as BCBSVT business rules. The platform also provides trading partners and groups with real time reporting as BCBSVT processes their EDI files and HIPAA level validation and error reporting that was not available with the current EDI platform."

    - Bob West, Director of Core Applications

Overview

Edifecs Smart Trading delivers interoperability in a single healthcare information pipe. Use Edifecs SpecBuilder and XEngine Server products to connect and control partner interactions. Connect using both standardized and proprietary formats. Control interactions and increase data quality and compliance. Edifecs Transaction Management puts answers at your fingertips to serve all of your programs and partners more efficiently. Increase customer service responsiveness and resolve issues quickly. Accelerate your programs by using an industry leading integration engine that can support the exponential growth of digital healthcare data.
#

Product Spotlight

  • XEngine Server

    Edifecs XEngine Server delivers unmatched performance and throughput for data validation and data transformation. XEngine Server minimizes processing delays, reduces integration challenges and increases first-pass rates. And, in-stream processing allows transactions to be validated against standards (HIPAA/EDI, HL7, NCPDP, etc.), and enriched through data lookups, code set verification (ICD-10), and business rules—increasing the integrity of partner exchange.

  • Transaction Management

    Edifecs Transaction Management offers innovative end-to-end information visibility including member and family journals, and longitudinal views integrating clinical and administrative data. Be proactive and avoid data silos by making informed decisions before data context is lost. Take action with exception management workflows and facilitate proactive communication internally and with partners.  Answer provider and member queries with ease. Finally, provide deep insight into every step of transaction lifecycles.

  • SpecBuilder

    Edifecs SpecBuilder delivers the knowledge component you need to keep up with changing mandates (HIPAA, Operating Rules, Meaningful Use, CAQH) and industry data exchange standards (XML, EDI, CSV). Capture business requirements and data semantics in a structured way. Then, build a core foundation for data liquidity that can be leveraged for all lines of business and multiple downstream applications.

Capabilities

Smart Trading is an industry-leading healthcare integration engine. Connect efficiently and govern data exchange to create interoperability with all your partners. Then, correlate clinical and administrative data to access real-time visibility of member interactions. Use Smart Trading to create the data and process foundation to consume the exponentially growing digital healthcare data that is essential to shifting to value-based care programs.

Learn how Smart Trading can be used in your business.


 

Approach

Smart Trading is uniquely positioned at the front end of the information pipe between healthcare entities to scale their partnerships. Harness our industry-leading integration solution to power agile applications and collaboration tools to automate the new business models driving your partnerships.

Edge-based innovation best supports industry initiatives. Its natural advantage is the ability to quickly connect and integrate, validate transactions to reduce downstream costs and provide actionable data to improve service.


 

Industry Initiatives Enabled

RETAIL ORIENTATION & CONSUMERISM

Payers need to connect to new partners such as public and private exchanges. These partners exchange enrollment and payment data that consists of multiple transaction types such as additions, changes and full-file audit

POPULATION HEALTH MANAGEMENT

Interoperability is fundamental for scaling population health initiatives. This creates requirements to integrate clinical data from multiple sources into a single comprehensive view of the patient

ADMINISTRATIVE 
SIMPLIFICATION

Measuring value requires exchanging clinical outcomes for comparison to previous year and industry norms. Value Based Reimbursement also requires the exchange of budget, member attribution data, etc., for successful administration

SHIFT FROM 
VOLUME TO VALUE

Reducing administrative costs requires automation and use of standards prescribed by HIPAA, CAQH CORE, etc.   Administrative simplification streamlines payer / provider processes by increasing automation rates

What can we do for you?

Get Expert Advice

Quickly get your project assessed and started


Get Connected

Receive updates on social media

Contact Us

Request a demo or ask a question