Edifecs and HealthEdge, Two Best in KLAS Technology Vendors, Announce Strategic Partnership to Deliver Seamless Healthcare Data Exchange

Edifecs® and HealthEdge® today announced a new partnership that natively integrates Edifecs’ EDI Gateway offerings and HealthEdge’s HealthRules Payer claims adjudication system. The partnership will make it easier for payers to exchange and connect healthcare data – reducing friction, strengthening business agility, and enhancing operational efficiency. Additionally, the alliance will dramatically shorten implementation times and streamline maintenance to reduce health plan total cost of ownership typically experienced with bespoke or in-house integrations.

“At HealthEdge, we are committed to building a single digital ecosystem that delivers advanced automation and clinical engagement among healthcare payers, providers, and patients.” said Alan Stein, chief product and strategy officer of HealthEdge. “Both HealthEdge and Edifecs are multi-year winners of the Best in KLAS award in our respective product areas. This partnership combines the strengths of two market leading companies. It ensures our mutual customers have solutions that further optimize their healthcare data exchange and are perpetually compatible and future-proof.”

With this partnership, Edifecs and HealthEdge will unlock greater visibility and ownership of end-to-end claims data for shared customers.

“HealthEdge is the vendor of choice for payers seeking state-of-the-art claims adjudication capabilities and Edifecs is the unmatched leader for strategic interoperability solutions. As industry-leading technology organizations, we realize that by working together, we can deliver incredible value to our joint customers and advance our shared mission of driving down the cost of healthcare. By developing native integrations between our unique technologies, we will dramatically reduce downtime, development and testing expenses, and administrative burden for our customers,” said Chris Lance, chief product officer at Edifecs. “Our partnership puts the heavy lifting on us – where it belongs – rather than on our customers.”

Part of the Edifecs Interoperability Cloud, EDI Gateway is the proven “gold-standard” for delivering high-performance real-time and batch X12 transaction processing, validation, and downstream system integration. Edifecs products ensure cost-effective, evergreen adherence to ever-changing regulations and industry standards, enabling HealthEdge customers to efficiently manage all front-end processes – including partner onboarding, transaction audits, and error reporting.

HealthRules Payer stands at the forefront of next-generation Core Administrative Processing Systems, leveraging cutting-edge technology to revolutionize healthcare operations and improve the financial performance of health plans. It empowers organizations with the agility to expand their product and service offerings seamlessly, ensuring scalability and adaptability in a rapidly evolving industry. HealthRules Payer helps organizations navigate complex regulatory landscapes with confidence while paving the way for future innovations in healthcare administration.

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About Edifecs

Edifecs provides market-leading technology to its payer and health system customers, which serve nearly 300 million people in the U.S. healthcare market. For over 25 years, Edifecs has enabled customers to unlock greater value with their healthcare data management platform which includes its Best in KLAS healthcare interoperability cloud solution. Edifecs’ healthcare SaaS solutions, available on both public and private clouds, serve as the foundation that eliminates stakeholder friction to overcome healthcare’s biggest challenges, including accelerating value-based payment adoption and obtaining more complete and accurate care funding for alternative payment models. Edifecs’ solutions are powered by AI that incorporates generative AI and LLMs, natural language processing, and machine learning, to provide deeper insights into patients, populations, and business processes. As new standards and regulations continually emerge from government agencies, Edifecs is a proven partner to support its customers road to “evergreen” compliance. Edifecs customers include 24 of the 25 top commercial health plans in the country, 29 of the 52 Medicaid programs, and 6 out of 10 of the largest health systems.

About HealthEdge

HealthEdge® is on a mission to drive a digital transformation in healthcare. We connect health plans, providers, and members with end-to-end digital technology solutions to support rapid member growth, new business models, and improved health outcomes. The next-generation healthcare SaaS company provides an integrated ecosystem of advanced solutions for core administration (HealthRules® Payer), payment integrity (HealthEdge Source), care management (GuidingCare®), and member experience (Wellframe). HealthEdge solutions – deployed as standalone next-generation SaaS or together as an integrated single ecosystem – help payers automate and digitize their core administrative and clinical care systems. Together with our customers and employees, HealthEdge is committed to innovating a world where healthcare can focus on people.

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