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.

Explore the Healthcare Cloud

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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Other Industries
We help government agencies manage costs, improve data quality and access while achieving ongoing compliance and trading partner satisfaction.
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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.

Edifecs customers are creating a more connected healthcare industry using our Best in KLAS interoperability platform. We are helping them change the game by providing them the solutions to:


Proven Healthcare Leadership

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Leading Health Plans, Providers, and Government Agencies

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Years Experience

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U.S. Lives Covered by Edifecs Clients


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Best in KLAS: CMS Interoperability - 2024
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Opportunity awaits. Are you ready to join the healthcare transformation?

Learn how Edifecs can help you achieve these outcomes.

News & Insights

Growth Without Constraints: Reducing Risk & Improving Scalability with the Edifecs EDI Gateway
In this case study, we take a look at how successfully migrating their Smart Trading solution to the hybrid SaaS environment of the Edifecs EDI Gateway has helped the plan reduce IT workloads, become more flexible in managing their EDI transactions, and focus more on growing their business.
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Edifecs Introduces Healthcare Interoperability Cloud
Edifecs FHIR and EDI Solutions, Foundational for Strategic Interoperability and CMS-0057-F Compliance, Named Leaders in Independent Payer Market Study
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Going Beyond Compliance with Edifecs’ FHIR® Gateway
See how Edifecs’ FHIR Gateway solution helped a health plan not only achieve compliance with CMS-9115-F, but allowed the plan to fully maximize the benefits of implementing FHIR APIs as well.
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Concurrent Risk Adjustment Data Sheet
Learn how to collaborate more effectively with provider partners and close diagnosis gaps early, without intrusive technology or processes.
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Choosing The Right AI Solution
In this infographic, we share the key questions healthcare leaders and executives should ask AI vendors—and the questions they should ask themselves—to ensure they select the right solution for their needs.
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The Transformation Imperative Playbook
A playbook for connected, collaborative, and intelligent healthcare transformation.
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