Skip to content
2020

Edifecs, a COTIVITI company, is a leading healthcare technology company with the mission to improve healthcare outcomes, reduce costs, and accelerate innovation by optimizing the end-to-end process of patient data interchange.

Picture1

Healthcare Data Interoperability

The Edifecs Healthcare Interoperability Cloud combines our EDI, FHIR, and Smart Trading platforms to seamlessly connect systems, processes, organizations, and people across the entire healthcare ecosystem.

·      EDI Gateway

Optimize data processing, reduce interoperability workloads, and support all X12 HIPAA-compliant transactions with a single EDI solution.

·      FHIR Gateway

Comply with CMS Interoperability mandates 9115 and 0057. Reduce provider abrasion and improve ALR by orchestrating FHIR-based electronic prior authorization submissions.

·      Smart Trading Platform

Automate business processes, modernize your technical infrastructure, and reduce costs.

Workflow & Data Enrichment

The Edifecs Healthcare Operations Cloud enables users to holistically apply their data across the major facets of their business to support the entire member journey—from contracting and enrollment through encounter submissions and prior authorizations.

·      Member Enrollment

Simplify and streamline enrollment management processes to capture a greater market share across all lines of business.

·      Encounter Submissions

Break down encounter operations silos, support submission accuracy, and ensure compliance

·      Member Consent Management

Effectively manage member consent by capturing and enforcing federal, state, CMS, and enterprise data-sharing policies according to member preferences.

·      Risk Adjustment

Maximize your resources to find more risk-adjustable opportunities faster and ensure ongoing compliance.

·      Value-Based Payments

Design, automate, and administer value-based contracts for more accurate payments and faster scaling of value-based programs.

Scroll To Top