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Edifecs Unveils Payer-to-Payer Data Exchange and Member App for FHIR® Solutions

October 18, 2022

BELLEVUE, Wash. – October 18, 2022 – Edifecs, Inc., a global health information technology solutions company, today announced its cloud Payer-to-Payer Data Exchange and Member App for FHIR® solutions are approved and published on the Council for Affordable Quality Healthcare (CAQH) Endpoint Directory. These solutions enable payers to leverage their Fast Healthcare Interoperability Resources (FHIR) investment to make data sharing easier with members and other payers while improving the member experience.

“These solutions represent an important step towards achieving national interoperability to empower healthcare consumers and improve health outcomes,” said Venkat Kavarthapu, CEO of Edifecs. “With more than a quarter century of experience building a robust interoperability platform leading to 40 patient access implementations, Edifecs is uniquely equipped to help create a fully interoperable and transparent healthcare system that enables value-based care, automated prior authorization, and more.”

As part of the Centers for Medicare & Medicaid Services’ Interoperability and Patient Access mandate, payers are required to share member data with other payers at the member’s request. This can result in major administrative challenges in developing and maintaining a compliant solution and obtaining credentials for data exchange with multiple payers. Edifecs’ new Payer-to-Payer Data Exchange solution, a SaaS offering, solves this issue for the payer by enabling real-time data exchange in FHIR between payers and securely authenticating and automating the data transfer from members’ old health plans to their new health plans. This seamless exchange of member data also provides payers a foundation for better member population analytics.

While the Payer-to-Payer Data Exchange solution eases data flow between payers, Edifecs is also helping the member navigate a disjointed and costly healthcare system where their health history and information does not follow them. This can lead to uninformed and suboptimal health outcomes. To improve the member experience, Edifecs’ Member App for FHIR empowers members with a comprehensive view of their healthcare data. Through the easy-to-use app interface, members can also perform a drug and provider search to connect them with the care they need.

These solutions are just the latest contributions to interoperability from Edifecs. As a founding member of the HL7® Da Vinci Project, Edifecs carries compliance expertise, backed by innovative Clinical Documentation Improvement (CDI) solutions, that have been validated and tested over time. This has contributed to Edifecs’ ability to anticipate, manage, and adapt to industry drivers in near real-time. Most recently, Edifecs launched a solution that automates prior authorization from the provider’s electronic medical records to the payer’s utilization management.

The Payer-to-Payer Data Exchange and Member App for FHIR solutions are both available in the U.S. today. To learn more about these solutions, please visit https://www.edifecs.com/solutions/fhir-solutions.

 

About Edifecs
Edifecs is a premier technology company in the US Healthcare market with solutions focused on interoperability, workflows, value-based care analytics, and payment programs. With innovative technology and solutions, Edifecs helps its customers by optimizing the secure exchange and processing of administrative and clinical data, reducing the cost of meeting various regulations, and automating workflows involved in multiple core processes within the healthcare ecosystem. Edifecs is a frontrunner in bringing new technology for B2B data exchange in healthcare streamlining business processes from “card to care,” and reducing the industry burden associated with data provisioning at the points of enrollment, care, payment, and reporting. With the advent of FHIR and new regulatory guidance from HHS, Edifecs has emerged as a leader in easing the effort associated with achieving compliance with new federal rules and in making the healthcare consumer the primary stakeholder. The company is headquartered in Bellevue, Washington, with additional offices in Atlanta, Georgia, San Francisco, California, Pittsburg, Pennsylvania, and Mohali, India, an engineering center in Moldova, Belarus and Ukraine, and has more than 1,000 employees.

 

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Media Contact:
Janet Hohmann
425-435-2894
Janet.Hohmann@edifecs.com