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
Collaborate with providers, automate manual processes, lower costs, and drive incremental revenue with our interoperability platform and workflow solutions.
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Healthcare Providers
Embrace alternative payment models and reduce friction while supporting care delivery and patient outcomes with our interoperability platform and workflow solutions.
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Government Agencies
Apply innovative, modern technology to eliminate excessive 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 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?

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


Staying Informed About Regulatory Changes, Industry Standards, and Technological Advancements to make Informed Decisions

The world of healthcare is constantly changing – both in terms of our tools and inventions and in how we approach things and where our priorities are at.

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Edifecs Tops Best in KLAS for CMS Payer Interoperability Category for the Second Year in a Row

Edifecs interoperability solutions enable compliance with CMS Interoperability and Prior Authorization Final Rule

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Population Payment Management for Value-Based Care Programs

In this brochure, we provide an in-depth description of our value-based payment and insight solution to enable the development, monitoring, optimization, and reporting of value-based care programs.

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Mandates Continue to Drive Healthcare Technology Advancements and Adoption

While telemedicine and digital health records have helped revolutionize health equity, person-centered care, and access, it is regulations in the healthcare space that are pushing forward the next generation of technology across the industry.

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The Power of Data Interchange and Interoperability Edifecs

To succeed in value-based programs, health plans and providers need to fully understand the needs, risk factors, and costs of their members and patients.

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What are the 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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