Encounter Submissions
The Power to Transform Your Operations
Regulatory requirements and operating demands are becoming more complex, and the resulting administrative costs and revenue leakage are shrinking financial margins. More effective collaboration between payers and providers can reduce costs and complexity and improve patient experiences—but first, they need to break down their functional silos.
The Edifecs Healthcare Operations Cloud is the key to turning your data into value, enabling you to leverage your unified health data and maximize its utility across all areas of your operations.
Make Your Data Work For You
With the Edifecs Healthcare Interoperability Cloud, our data management and integration platform, users can seamlessly connect and unify data from clinical, financial, and administrative systems and processes to build a complete longitudinal record of each member. But to truly unlock operational efficiencies and reduce costs, that data has to be put to good use. We help make that happen.
The Edifecs Healthcare Operations Cloud enables users to holistically apply their data across the major facets of their business. Our robust portfolio of plug-and-play solutions supports the entire member journey—from contracting and enrollment through encounter submissions and prior authorizations—to support better business, financial, and member outcomes.
Our proven and powerful AI technology helps ensure insights are effectively incorporated into your workflows. And with complete visibility across each function via the Edifecs Analytics Center, it's easier than ever for payers and providers to work together to lower administrative costs, eliminate revenue leakage, and drive healthcare transformation.
Healthcare Operations Cloud Solutions
Enrollment Management
Prior Authorization
Risk Adjustment Clinical Suite
Risk Adjustment Coding Suite
Value-Based Payment & Insight
Manage complexity
Eliminate functional silos for a more comprehensive view of operations
- Lower implementation costs and overhead with plug-and-play applications
- Equip non-technical personnel to meet changing business needs without straining IT resources
- Unify and analyze financial, clinical, and administrative activities for more effective collaboration
Maximize efficiency
Unify workflows and processes across your organization
- Maximize the utility and reusability of your data by connecting technical and operational silos
- Innovate and adapt more easily to changing organizational, regulatory, or business needs
- Unify data across business processes impacted by Edifecs applications
Intervene early
Leverage insights to drive better business and member outcomes
- Inform your operational strategy with AI-powered data analytics
- Analyze, automate, and enhance critical workflows with Edifecs’ applications
- Deliver a more comprehensive and cohesive end-to-end experience for all stakeholders
Meaningful Intervention and Member Empowerment
Edifecs connects systems, processes, and people across the healthcare continuum. Our solutions support more effective clinical, financial, and administrative operations and enable stakeholders to measure the impact on their organizational objectives.
Data Standards + Interoperability Leadership
