Edifecs

Powering Intelligent Healthcare Transformation

Healthcare is evolving. So are we.

For over 25 years, Edifecs has been a market leader in healthcare data interchange. Hundreds of health plans, providers, and government agencies rely on our interoperability solutions to unify, normalize, and exchange clinical and financial data. As the healthcare industry has evolved, our solutions have evolved with it. Our cloud-native, AI-powered solutions are designed to help healthcare organizations thrive in value-based care.

Who We Serve

Health Plans
Collaborate with providers, automate manual processes, lower costs, and drive incremental revenue with our interoperability platform, value-based payments processing, and workflow solutions.
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Healthcare Providers
Thrive in alternative payment model arrangements, reduce administrative burdens, and support care delivery and outcomes with our interoperability platform, risk adjustment, prior authorization, and workflow solutions.
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Government Agencies
Apply innovative, modern technology to eliminate administrative, maintenance, and compliance challenges while creating a more equitable care framework.
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Integration. Collaboration. Interoperability.

Edifecs is the strategic partner that links payer and providers to improve collaboration and accelerate healthcare evolution
How will Edifecs’ solutions benefit you?

Let’s take a look.

Friction
Connectivity
Efficiency
Costs
Collaboration
Revenue
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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?

Payers. Providers. Patients. Connected.

Edifecs’ AI-infused platform and business applications help payers and providers innovate, collaborate, and ultimately deliver better care.

It's time to change the game.

News & Insights

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Separating Truth from Hype in Healthcare AI

Over the past year, we’ve seen a rapid expansion of potential use cases for AI, and everyone wants a piece of the action.

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AI in Healthcare: Truth vs. Hype

Artificial intelligence will reshape the healthcare landscape—for better or worse, depending on how the technology is defined and applied

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Risk Adjustment Clinical Suite: The Key to Value-Based Success

By delivering better satisfaction, better clinical outcomes, and better population health, value-based care can transform healthcare.

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AI-Powered Risk Adjustment Coding Suite Explainer Video

To succeed in value-based care, health plans need to take advantage of every opportunity to maximize revenues and ensure complete, accurate payments.

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RISE National 2024: What We Learned

Insights and lessons learned from this year’s RISE National Conference

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Cost Implications of Implementing Cloud Technology in Healthcare

We have talked about implementing cloud technology in healthcare a lot, but there are still a lot of gray areas, such as the cost implications. Will it increase or reduce healthcare costs? More importantly, if we are looking to switch from the traditional on-premises infrastructure, how do the costs compare? Both in where we are today and in the long run?

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