Government Agencies

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Modernize. Innovate. Comply.

Managing an ever-increasing flow of patient data in a complex regulatory landscape can create logistical and operational challenges that are costly and resource intensive to address. Edifecs’ AI-powered SaaS solutions help government agencies harness and connect disparate data and modernize their interoperability infrastructure. Our solutions amplify your core technological ecosystem, simplifying compliance with regulatory mandates and putting you in position to achieve your public health objectives.
Government agencies like the Centers for Medicare and Medicaid Services, the Department of Veterans Affairs, and the majority of state Medicaid agencies use Edifecs’ standards-based data exchange to deliver continuous compliance, improve data quality and timeliness for all stakeholders, and accelerate the pace of modernization.

Solving Key Issues Together

Ongoing Compliance
HIT Enterprise Agility
Transparent Data Exchange
Interoperability and Consent

Solutions for Government Agencies

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intervene

  • Incorporate suspected conditions into pre-visit planning workflows
  • Help providers ask the right questions and support better care outcomes
  • Support retro review workflows with targeted chase lists for record retrieval

Get involved earlier

Take a more proactive approach to patient care

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uncover

  • Capture up to 30% more conditions than claims-based suspecting
  • Incorporate more than 90% of all available patient data into risk adjustment systems
  • Surface suspects for coder review ahead of patient visits

Spot the opportunities

NLP Suspecting has a 95% accuracy rate for risk category capture

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extract

  • Increase RAF value by up to 10% with NLP-derived suspects
  • Synchronize industry best practices, CMS policies, and customizable business rules
  • Accommodate FHIR standards or flat files with flexible data integration capabilities

Apply your information

Easily ingest clinical and claims data for faster review by clinical teams

Find out how we can support your health plan's performance.