Edifecs Tops 2023 Best In KLAS for New CMS Payer Interoperability Category

Edifecs’ flexible, comprehensive platform, Smart Trading, supports all healthcare interoperability standards including FHIR

BELLEVUE, Wash.–(BUSINESS WIRE)–Edifecs, Inc., a global health information technology solutions company, today announced the Edifecs interoperability platform, Smart Trading XEngine Server for FHIR®, has been named the market leader by KLAS Research in its 2023 Best in KLAS: CMS Payer Interoperability Report. Edifecs was ranked as the leader among vendors that provide software designed to meet the requirements for CMS-related payer and state agencies by providing patient access API, provider directory API, and payer-to-payer data exchange. Edifecs has over two decades of experience helping hundreds of its healthcare customers achieve ongoing interoperability and compliance. Edifecs serves 100% of national health plans, 70% of state Medicaid programs, and 94% of the lives covered by Blue Cross Blue Shield.

The Best in KLAS award furthers Edifecs’ recognition as the market standard for administrative, pharmacy, and clinical standards. Additionally, Edifecs is the vendor of choice by CMS for verifying industry data via its administrative simplification testing tool and by CAQH for industry operating rules certification.

“We are honored to be recognized by KLAS in the inaugural year of the CMS Payer Interoperability category. 26 years ago, Edifecs began building products to solve interoperability and data transaction challenges. With our expertise we have developed an interoperability platform that serves as a unified gateway supporting all data standards, powering data exchange across healthcare stakeholders,” said Venkat Kavarthapu, CEO, Edifecs. “Our customers serve more than 290 million people, as a result, we have a wealth of experience with customer data and processes. This deep expertise has helped make our platform the proven choice to future-proof capabilities and ease the adoption of new compliance mandates. We’ve continued to leverage our industry know-how to provide business solutions that accelerate value-based payment adoption, obtain complete and accurate funding, and fully automate prior authorizations. Together, these solutions help replace the pervasive friction between payers, providers, and members with collaboration.”

Edifecs is the only vendor that provides a unified interoperability solution that enables the exchange of any kind of data between partners. This is a significant differentiator and a major contributor to Edifecs being awarded Best in KLAS. In addition to FHIR, the Edifecs platform enables the exchange, unification, and processing of all data including proprietary flat files, healthcare administrative transaction files, pharmacy data, clinical data, and unstructured data. With the Edifecs platform, customers do not need to maintain multiple IT solutions, work with multiple vendors, or spend additional money on multiple systems.

“The 2023 Best in KLAS report highlights the top-performing healthcare IT solutions as determined by extensive evaluations and conversations with thousands of healthcare providers. These distinguished winners have demonstrated exceptional dedication to improving and innovating the industry, and their efforts are recognized through their inclusion in this report. Congratulations to all winning vendors for setting the bar for excellence in healthcare IT! KLAS continues to be committed to creating transparency and helping providers make informed decisions through accurate, honest, and impartial reporting,” said Adam Gale, CEO, KLAS.

“Electronic data interchange is essentially interoperability between partners using electronic data,” said Vik Sachdev, head of healthcare data interoperability products, Edifecs. “We have enabled data flow and collaboration between partners for a very long time. Therefore, when it comes to new ways to exchange data and interoperability – the core principals, processes, and mechanisms are not new to Edifecs. Our platform is incredibly flexible and modern, so we were able to quickly leverage it to add support for the new FHIR standards.”

About Edifecs

Edifecs is a premier technology company serving the U.S. healthcare market that empowers its customers to transform healthcare. For over 25 years, Edifecs has provided the market-leading interoperability platform. Edifecs payer and provider customers and technology partners are driving healthcare transformation with the ability to seamlessly exchange, unify, and normalize data to derive insights and intelligence and replace friction with collaboration across all stakeholders. Edifecs’ deep industry expertise is the foundation to help customers overcome healthcare’s biggest challenges, including accelerating the adoption of value-based payment models, obtaining complete and accurate care funding for alternative payment models, and fully automating prior authorization. Edifecs uses natural language processing, machine learning, and artificial intelligence to provide deeper insights into patients, populations, and business processes. As new standards and regulations continually emerge government agencies, Edifecs is a proven partner to ensure its customers maintain “evergreen” compliance. Edifecs customers cover 290 million lives and include 100% of national health plans, 70% of state Medicaid programs, and 94% of the lives covered by Blue Cross Blue Shield payers.


Janet Hohmann



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