Health Plans
Collaborate with providers, automate manual processes, lower costs, and drive incremental revenue with our interoperability platform, value-based payments processing, and workflow solutions.
Ric Sinclair to
Join Cotiviti
as CEO
Learn how Cotiviti will shape the next era of healthcare innovation as Ric Sinclair joins the organization as CEO.
The Winning Strategy
to Interoperability
Starts Here
Enable strategic interoperability, support your digital health strategy, and comply with CMS-0057-F with the Edifecs Healthcare Interoperability Cloud.
We cannot solve our
problems with the
same thinking we used
to create them
-Albert Einstein
Edifecs is the flexible, reliable, and experienced partner trusted by more than 300 leading healthcare organizations.
We all have
natural curiosity
it's posing questions and
coming up with a method
-Sally Ride
Edifecs reveals insights that help you better understand risk and optimize care quality & health outcomes for individuals and populations.
Edifecs named 2026
Best in KLAS®
for CMS Payer
Interoperability
Learn more about this exciting announcement!
Powering Intelligent Healthcare Transformation
Healthcare is evolving. So are we.
For over 25 years, Edifecs has been a market leader in healthcare data interchange. Hundreds of health plans, providers, and government agencies rely on our interoperability solutions to unify, normalize, and exchange clinical and financial data. As the healthcare industry has evolved, our solutions have evolved with it. Our cloud-native, AI-powered solutions are designed to help healthcare organizations thrive in value-based care.
Who We Serve
Healthcare Providers
Thrive in alternative payment model arrangements, reduce administrative burdens, and support care delivery and outcomes with our interoperability platform, risk adjustment, prior authorization, and workflow solutions.
Government Agencies
Apply innovative, modern technology to eliminate administrative, maintenance, and compliance challenges while creating a more equitable care framework.
Other Industries
We help government agencies manage costs, improve data quality and access while achieving ongoing compliance and trading partner satisfaction.
