Health Plans

Connect. Collaborate. Automate.

The healthcare landscape is becoming more and more complex. To effectively manage that complexity, health plans need a robust and flexible tech infrastructure that can support their business operations. That’s what we deliver.

Edifecs’ SaaS-based modular solutions make it easier for payers to efficiently exchange and connect data to satisfy regulatory requirements and deliver a better member experience. By incorporating AI technology into our solutions, we help health plans glean valuable insights to inform operations and support growth in value-based care.

Backed by over a quarter century of healthcare experience and expertise, our solutions are the difference-maker health plans can rely on as they lead the way into the future of healthcare.

Solving Key Issues Together

Accelerate VBC Adoption

Be a Transformative Partner

Enhance Operational Efficiency

Improve Financial Performance


Solutions for Health Plans

Risk Adjustment
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Value-Based Payment & Insight
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Enrollment Management
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Healthcare Data Unification
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Prior Authorization
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Find out how we can support your health plan’s performance.

Resources

AI in Healthcare: Truth vs Hype
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Flexibility and Control: Growing with Edifecs Enrollment Management
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Meaningful Applications for Healthcare AI Webinar
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