Healthcare Data Interoperability

The real-time sharing of data across the healthcare ecosystem helps improve consumer experience and enhance health outcomes.

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Connection. Collaboration. Compliance.

Activate better interoperability across your hardware, services, and applications with the Smart Trading platform. You’ll get scalability, better security, and faster sharing of information across multiple locations and workstations. Edifecs has 26 years of interoperability and IT experience to help you with building accurate and precise data connections and meeting the requirements for FHIR®-based interoperability mandates. Through constant solution innovation and a managed-SaaS model, Edifecs clients are able to focus on interoperability priorities while deploying less IT infrastructure.

Infographic - Healthcare Data Interoperability


Comply with Interoperability FHIR® Mandates

Enable continuous compliance with CMS FHIR® mandates. Streamline and standardize the exchange of clinical and financial data between payers and providers for real-time interoperability and compliance using FHIR® APIs.

  • Jump-start your FHIR® development using the Smart Trading platform without investing significant time and resources
  • Share FHIR® information with developers, members, and third parties in an expedient intuitive platform experience
  • Deploy interoperability solutions developed by professionals with nearly 50 implementations and 26 years of proven expertise in data exchange

Quickly meet requirements for the Interoperability and Patient Access mandate with future-proof FHIR® APIs.

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Achieve Optimization with Digital Modernization

The Smart Trading platform can help you scale in existing markets or expand into new markets.

  • Award-winning toolset for specification building and QA testing
  • Unmatched performance to validate, transform, and process healthcare transactions
  • Deep insight into the healthcare transaction lifecycle for proactive interventions
  • Automation of cross-enterprise workflow into existing claims and clinical systems
  • Simplified clinical data integration and comprehensive support for interoperability standards
  • Leverage the Gold standard for HIPAA validation and compliance
  • Save time on maintaining routine processes for real-time and batch interoperability transactions

Harness all available data into meaningful transactions that drive business initiatives and enable administrative, clinical and pharmacy automation. Industry-leading run-time engine for data exchange and high-performance transaction processing.

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Save Money with Electronic Attachments

Enable operational efficiency, provider collaboration, and faster reimbursement times with automated and secure attachment exchange.

  • Integrate with backend systems and existing provider portals
  • Automate cross-enterprise workflows through any channel

Save money by switching to electronic claims and prior authorization attachments.

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Meet Compliance Cost Effectively

Ensure HIPAA compliance and peace of mind knowing that your eligibility, claims status, and electronic funds transfer (EFT) transactions are reaching their final destination in a timely fashion.

  • Perform HIPAA and CORE validations of transactions and implement CORE-compliant connectivity protocols and authentication
  • Perform ongoing compliance surveillance by tracking responses/acknowledgments and their timeliness, eligibility data content errors and AAA errors, ERA and EFT re-association, and CARC/RARC errors
  • Gain insights with error reporting and statistics in dashboards
  • Perform Production-Level Testing with access to comprehensive test cases covering most of data content as well as infrastructure rules
  • Identify implementation gaps with access to intuitive Operating Rules dashboards
  • Reduce provider abrasion with better data quality

Reduce the cost and time needed to achieve HIPAA and CAQH CORE compliance with a configurable HIPAA and CORE validation and orchestration engine.

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