Leverage cutting-edge machine learning and artificial intelligence solutions for next-generation healthcare.
Edifecs Smart Decisions combines the fundamental building blocks required to derive quantifiable value from healthcare data into a single solution approach. This approach includes a platform of tools integrated into a common data store as well as machine learning algorithms designed by data scientists with a deep understanding of the healthcare domain.
Edifecs enables health plans to bring the power of AI and Machine Learning to their core operational processes. Claim and encounter processing, care management, provider management and pharmacy management all benefit from increased efficiency and effectiveness of AI enhancement.
Edifecs can assist State Medicaid Agencies by bringing Machine and Deep Learning to their Population Health efforts as well as abuse monitoring programs.
Edifecs can help providers improve revenue by enhancing their claims payment process, decreasing rework and denial percentages and reducing administrative costs. The Smart Decisions platform can also better target “at risk” patients and close gaps in care.
PBMs need an effective means to bridge the gap between pharmacy and medical data to improve their members’ health and identify fraud, waste and abuse. Edifecs solutions support this integration as well as provide Machine Learning solutions to drive even greater value.