Edifecs, Inc Among Apps Top 500

1756 114th Avenue SE

Bellevue, WA, 98004, United States

1 425-435-2000



Edifecs, Inc Strengths, Domain Expertise, and Key Differentiators

Edifecs focuses on solving big problems in the healthcare industry. It's software solutions and services simplify burdensome processes, reduce layers of cost, and improve healthcare efficiency. Edifecs empower healthcare organizations to scale the partnerships required by payment, care delivery, and access reform initiatives that are redefining the healthcare industry. Edifecs has more than 350 customers, including 250 in healthcare.

Edifecs, Inc Recent Developments

In April 2020 Edifecs launched a dashboard that provides the ability to analyze claims information from COVID-19 test data. The dashboard, which is built into the Edifecs Visualizer part of XEngine Server Manager & SpecBuilder tools, allows customers to synthesize data related to COVID-19 testing to ensure scalability and prioritization of testing while understanding and tracking economic impacts. The XEngine Server delivers enhanced interoperability and the ability to ingest, validate, transform, and consolidate siloes of data seamlessly from any connection point or in any format in order to share the data.

The Edifecs COVID-19 dashboard will provide Edifecs’ health plan customers the ability to track how much of their population has been tested for COVID-19 using both the current virus genetic test and the upcoming antibody tests. Users of the Visualizer COVID-19 dashboard can filter data between different types of tests and codes, analyze the data based on gender and age, determine testing trends over time, including which providers are doing an effective job of testing and which ones may need additional assistance. The data can be viewed at the macro and more narrowly at the member level.

In September 2018, Edifecs has been selected by the Blue Cross Blue Shield Association (BCBSA) to help drive the adoption of HL7 Fast Healthcare Interoperability Resources (FHIR). Edifecs’ user-friendly Edifecs XEngine Server Module for FHIR will be offered to Blue Cross and Blue Shield (BCBS) companies to support the rapid deployment of HL7 FHIR data standards with minimal training required.

Edifecs focuses squarely on the healthcare IT space. Unveiled SmartAttach, which simplifies document exchange and sharing processes between payers and providers, and links the attachments to patients’ records and claims. The product is expected to help eliminate errors, reduce manual procedures, and integrate systems for all the key stakeholders in the healthcare market.

Edifecs, Inc Mergers and Acquisitions (M&A) Activities

In September 2021, Edifecs, Inc., a health information technology solutions company, acquired Talix, an information technology company that provides risk and quality solutions to healthcare payers and providers.

Edifecs, Inc Customers in ARTW Customer Database

Leveraging a rigorous data-centric research methodology, APPS RUN THE WORLD asks the simple question: Who’s buying Edifecs, Inc applications and why? And we provide the answers – supported by decades of research – to our clients around the world. Our Customer database has over 100 data fields that detail company usage of Edifecs, Inc and other enterprise apps by function, customer size, industry, location, implementation status, partner involvement, Line of Business Key Stakeholders and IT decision makers contact details. List of Verified Edifecs, customers.

Edifecs, Inc Overview

Ownership: - x

Number of Employees: 850

Functional Markets: ERP Services and Operations Management,

Key Verticals: Healthcare,

Edifecs, Inc Key Enterprise and Cloud Applications


Edifecs, Inc Revenues, $M:

Type/Year 2020 2021 YoY Growth, %
Total Revenues, $M Subscribe Subscribe Subscribe
Enterprise Applications Revenues, $M Subscribe Subscribe Subscribe
Cloud Applications Revenues, $M Subscribe Subscribe Subscribe

* Enterprise Applications Revenues = License + Support & Maintenance + SaaS
** All revenue figures are estimates based on public records, Cloud and Non-Cloud business models in Apps Run The World's vendor database, and annual survey results including vendor feedback.

Edifecs, Inc Revenue Breakdown By Type, $M:

Type License Prof. Services Hardware Support & Maintenance SaaS PaaS IaaS Other (Non Enterprise Application Revenues) Total
% of Total Revenues Subscribe Subscribe Subscribe Subscribe Subscribe Subscribe Subscribe Subscribe 100%
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Edifecs, Inc Revenues By Region, $M

Region % of Total Revenues 2021 Total Revenues, $M 2021 Enterprise Applications Revenues, $M 2021 Cloud Applications Revenues, $M
Americas Subscribe Subscribe Subscribe Subscribe
EMEA Subscribe Subscribe Subscribe Subscribe
APAC Subscribe Subscribe Subscribe Subscribe
Total Subscribe Subscribe Subscribe Subscribe

Edifecs, Inc Direct vs Indirect sales

Region Direct Sales Indirect Sales Total
Type % Subscribe Subscribe Subscribe
Revenues, $M Subscribe Subscribe Subscribe

Edifecs, Inc Customers - Breakdown by Geo, Size, Vertical and Product

List of Verified Edifecs, Inc Customers

No. of Edifecs, Inc Customers: 400

No. of Edifecs, Inc Enterprise Applications Customers: 400

No. of Edifecs, Inc Cloud Customers: x

No. of Edifecs, Inc Cloud Subscribers: x

Among the 350 organizations worldwide that rely on Edifecs, more than 250 are U.S. based healthcare organizations. Edifecs’ growing customer base is predominantly comprised of payers and providers, as well as state and federal agencies.

The Company has achieved widespread market penetration within the Blue Plans, providing solutions to 25 out of the 37 BCBS Licensees. State Medicaid programs and CMS are also significant customers.

Provider demand for the Company’s products has grown with a provider becoming one of Edifecs’ top 20 customers for the first time in 2014. Overall, Edifecs serves over 215 million lives through its customers. Among Edifecs customers are the majority of Blue Cross Blue Shield Plans, Centene Corporation, ClearConnect, Centers for Medicare and Medicaid Services, Humana, MultiPlan, and many others.

Edifecs, Inc Market Opportunities, M&A and Geo Expansions

In May 2021, Edifecs, Inc., added four new executives to accelerate growth across multiple functions of the business. Dan Madden joins the company as chief financial officer, Lisa Anastos as general counsel, Sundar Shenbagam as senior vice president of engineering, and Scott Davis as associate vice president of product marketing and demand generation. In April 2018, Edifecs launched Edifecs SMB Solutions suite of products, including Smart Trading and Encounter Management for SMBs. The offerings were purpose-built to meet the unique needs of small and medium-sized health plans. It also announced the availability of its Encounter Management solution for small and mid-sized Managed Care Organizations (MCOs) and Medicare Advantage Organizations (MAOs).

The Encounter Management software-as-a-service (SaaS) model helps health plans facilitate the encounter data submission process in the transition from Risk Adjustment Payment System (RAPS) to the Encounter Data Process System (EDPS) with no infrastructure footprint.

The solution is delivered as a software as a service (SaaS) in order to be cost-effective for small and mid-sized MCOs and MAOs. These types of health plans are faced with added operational complexity and potential revenue leakage due to strict encounter data submission requirements and constantly changing rules published by CMS and State Medicaids.

Subject matter expert staffing challenges, infrastructure limitations, and budgetary constraints often increase encounter submission and reconciliation delays and prioritization. Edifecs develops software solutions that streamline the exchange and processing of healthcare information in real-time among payers, providers, and employers worldwide.

The company offers Unified Channel solutions that streamline the processing and exchange of administrative, financial, and clinical transactions; and regulatory solutions that help healthcare organizations achieve and maintain compliance.

Edifecs, Inc Risks and Challenges

In July 2021, Amid Strong Year of Growth, Founder Sunny Singh transitioned to the role of Chairman of the Board of Directors and Venkat Kavarthapu will become Chief Executive Officer. The convergence of EDI and secure Cloud delivery could define Edifecs' future as healthcare providers are pressed for new ways to reduce their costs under the Affordable Care Act.

Edifecs, Inc Ecosystem, Partners, Resellers and SI

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Edifecs and Microsoft have an active Channel Partnership according to www.edifecs.com. There are 21 companies in the Edifecs partner ecosystem and 1,689 companies in the Microsoft partner ecosystem. 9 companies exist in both ecosystems, representing 43% of the Edifecs parther ecosystem and 0.53% of the Microsoft partner ecoystem. Accenture and Tableau Software are the largest companies that exist in both ecosystems.

In April 2018, Edifecs has joined the MuleSoft Technology Partner Program to integrate Edifecs Smart Trading healthcare transaction processing and Compliance solutions with MuleSoft’s Anypoint Platform.

Edifecs has also released a MuleSoft Certified Connector to provide healthcare organizations with enhanced support for industry data standards and adherence to industry regulations such as ACA, HIPAA, and HITRUST. Currently, Edifecs is expanding beyond its large North American footprint to deliver solutions worldwide and adapting its technologies for customers in other industry verticals. It has offices in Chandigarh, India; Chisinau, Moldova; and Sevastopol, Ukraine.

Edifecs, Inc Cloud Infrastructure Insights

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Research Methodology

Data used in research reports are derived from publicly available documents, continuous surveys of applications vendors, customers, resellers, Independent Software Vendors, systems integrators and other verifiable sources.

Vendor shares and market forecast results are based on a combination of existing databases as well as demand side and supply side research conducted throughout the year with validation from vendors, customers, channel partners and documentations such as earnings releases and 10Q and 10K filings, vertical industry studies, regional and country-level statistics from public and private institutions(i.e. colleges, universities, government agencies and trade associations).

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