Empowering Intelligent Healthcare Transformation

For over 25 years, Edifecs has led the evolution of the healthcare data interchange process. Customers use our healthcare interoperability platform to unify, normalize and exchange disconnected clinical and financial data, allowing them to uncover the insights and intelligence required to drive an end-to-end alternative payment model ecosystem. This foundation enables us to provide purpose-built AI-powered solutions that accelerate value-based care adoption, optimize risk adjustment and payments, and overcome the complex, labor intensive prior authorization process.

Who We Serve

Health Plans
Easily collaborate with providers, automate manual processes, lower costs, and drive incremental revenue with our interoperability platform and workflow solutions.
Learn More  ❯
Healthcare Providers
Easily embrace alternative payment models and reduce friction while supporting care delivery and patient outcomes with our interoperability platform and workflow solutions.
Learn More  ❯
Government Agencies
Apply innovative, modern technology to eliminate excessive administrative, maintenance, and compliance challenges while creating a more equitable care framework.
Learn More  ❯

Integration. Collaboration. Interoperability.

Edifecs is the strategic partner that links payers and providers to empower collaboration and accelerate healthcare evolution.
How will Edifecs’ solutions benefit your organization?
Let’s take a look.

Explore Our Platform

Proven Healthcare Leadership

26+ Years Experience

Years Experience

Trusted By 300 Healthcare Companies

Leading Health Plans, Providers, and Government Agencies

292M Lives Covered

U.S. Lives Covered by Edifecs Clients

Opportunity Awaits. Are You Ready to Join the Healthcare Transformation?

Connect With Us

Payers. Providers. Patients. Connected.

Edifecs’ interoperability platform and business applications help payers and providers innovate, collaborate, and ultimately deliver better care. It’s time to change the game.

News & Insights

Washington D.C.

NAACOS Fall 2023 Conference – September 20-22

Edifecs is proud to be sponsoring this year’s NAACOS Spring conference in Washington, D.C.

Learn More  ❯

Edifecs Awarded for Global Sustainability

Sustainability Initiative of the Year award in Business Intelligence Group’s (BIG) 2023 Sustainability Awards

Learn More  ❯

Strategies to Improve Financial Performance

In this eBook, we explore how health plans can achieve both cost reduction and revenue maximization.

Read Now  ❯

3 Risk Adjustment Moves to Make Now Given Policy Changes and Compliance Scrutiny

In this webinar, hear the strategic adjustments industry experts recommend implementing now so you can be confident in your ability to sustain value-based care reimbursements compliantly and accurately as CMS continues to refine practices.

Learn More  ❯

True Interoperability: The Key to Transforming Healthcare

Download this white paper from the 2023 Best in KLAS in CMS Payer Interoperability winner, Edifecs.

Download Now  ❯
Technology and Value-Based Care Acceleration Edifecs Webinar

Webinar Recap: Healthcare Leaders Discuss Technology and Value-Based Care Acceleration

In this wide-ranging discussion, industry experts share their insights on how technology plays a pivotal role in successful VBC programming.

Read Now  ❯