Edifecs Releases Statement in Support of CAQH CORE and HL7 Collaboration Announcement

Collaboration will improve interoperability between administrative and clinical systems

BELLEVUE, Wash. – September, 23 2019Edifecs, Inc., a global health information technology solutions company, issued the following statement in response to CAQH and HL7’s announcement to collaborate on “address long-standing healthcare industry challenges by accelerating automation and improving interoperability between administrative and clinical systems.” Announced on September 19, 2019, the initial focus for this collaboration will be on automating the prior authorization process, transitioning from manual to electronic exchange of clinical and medical information, and addressing the interoperability challenges sparked by new reimbursement models such as value-based care.                                                                           

According to Edifecs:

“The collaboration between CAQH CORE and HL7 is a pivotal step forward as the industry moves towards value-based care models, adjusts to new encounter data management rulings from CMS and complies with new federal regulations around patient privacy. We believe a focus on improving the interoperability between administrative and clinical systems will result in the reduced risks for errors and revenue loss.

“This will help our industry to better streamline, analyze and scale large volumes of data across the healthcare ecosystem. It’s time that health plans start thinking about how they will leverage the new payer, provider and patient data exchange requirements to support efforts that drive new care payment models – this collaboration will make this a reality. This is a critical shift in creating a harmonized approach to dealing with the various existing and emerging standards supporting the exchange/movement of patient information between and among the industries stakeholders. Especially in emphasizing the patient role as a primary agent of interoperability.

“CAQH CORE and HL7’s collaboration is well-aligned with Edifecs’ mission to improve interoperability between payers and providers. As the go-to partner for a majority of the nation’s health plans, Edifecs supports compliance auditors, and has solutions ready for FHIR and the CARIN Blue Button framework to enable interoperability, and correlate clinical and administrative data to deliver real-time visibility for health plans.” 

For more than 20 years, Edifecs’ suite of data exchange technology has equipped health plans, providers, government agencies and ACOs with solutions for enabling interoperability, assuring compliance, correlating clinical and administrative data and delivering real-time visibility of each partner data exchange.