Edifecs

Understanding the timeline and key milestones for CMS-0057-F is crucial to ensuring compliance. Matthew Spielman breaks down what you need to consider in your planning process. https://lnkd.in/eW_BkWqR #interoperability #FHIR #payers #healthplans #healthcaredata #cms57f

Edifecs is now part of Cotiviti, a leader in data-driven healthcare solutions. Read our press release and learn how this acquisition will drive transformation in value-based care, interoperability, and streamlined operations for both payers and providers. https://lnkd.in/eTQgpC_R

The theme for National Doctors’ Day 2025 is “Behind the Mask: Who Heals the Healers?” encouraging us not only to express our gratitude for physicians’ unwavering dedication to their patients, but also recognizing their need for support and care. Physicians are tasked with high patient loads, administrative burden, and long hours, leading to stress and burnout. They selflessly put their patients first, often neglecting their own health and well-being. Today, we celebrate the countless physicians who dedicate themselves each day to caring for their patients and saving lives. Think about showing your appreciation for all they do—no matter how small the gesture. Happy National Doctor’s Day from Edifecs! #NationalDoctorsDay #DoctorsDay2025 #ThankADoctor

This Women’s History Month, we’re shining a spotlight on the incredible women who make Edifecs a great place to work. Throughout March, we’ll be sharing their stories, motivations, and insights as part of our #WomenOfEdifecs series. Our series continues with Stephanie Daly, Director of Marketing. ❓ Why are you passionate about Edifecs? What motivates you every day? Contributing to an organization that helps transform healthcare in this country is a fantastic motivator. Having been a patient in the system, I know how important it is to improve data connectivity and collaboration to drive better healthcare outcomes. ❓ Edifecs is a demanding company. How do you create work/life harmony? How do you decompress after work? I enjoy taking walks with my family and becoming one with nature—sometimes, just getting some Vitamin D and fresh air makes all the difference. My husband and I also love attending live music, movies, performances, and comedy shows—creating unforgettable memories. Traveling is another passion of mine; exploring history, different cultures, and nature around the world is always an enriching experience. ❓ What's one thing that few of your co-workers know about you? Having experienced my own challenging healthcare journey with bone cancer, I’m currently pursuing certification in patient advocacy. For over 10 years, I’ve helped others navigate the healthcare system—whether it’s understanding treatment options, insurance, or recovery. I’m excited to expand my knowledge and further support those in need. 🌟Join us in honoring the #womenofedifecs achievements, resilience, and contributions to the workplace and beyond. ✨ #NationalWomensMonth #WomenInTech

CMS’ Interoperability and Prior Authorization Final Rule includes a provision for payers to obtain patient consent to share medical information with other healthcare organizations. While the ruling is an important first step in giving members control over their health data, the provision fails to address a host of urgent challenges. 
    In a new article, Matthew Spielman, Senior Director, Product Management at Edifecs explores 5 of these challenges and what they mean for health plans. 
  
#CMS #healthcaredata #healthplans #interoperability #priorauthorization #healthcareblog #healthtech #payers   

The Edifecs team has been on the move, connecting with healthcare leaders at #HIMSS25 and #RISENational. From what’s next for Medicare Advantage to navigating CMS-0057-F, strategic interoperability, AI, and the future of value-based care, we're sharing where the industry’s headed and how to lead the way. Missed us at the conferences? No problem. Let’s talk about how Edifecs can help you power the next phase of intelligent healthcare transformation. https://lnkd.in/eUNHw3rf

New compliance mandates are inevitable—and the time to start planning for them is right now. Matthew Spielman explains how to evaluate your current systems and close the gaps in your interoperability strategy in this clip.  https://lnkd.in/eNVPNiri #FHIR #CMS57f #Interoperability #healthcaredata

This Women’s History Month, we’re shining a spotlight on the incredible women who make Edifecs a great place to work. Throughout March, we’ll be sharing their stories, motivations, and insights as part of our #WomenOfEdifecs series. Our series continues with Heather Kendall, People Experience Manager. ❓Why are you passionate about Edifecs? What motivates you every day?: I’m passionate about Edifecs because the company really focuses on creating a positive work culture where everyone feels heard and valued. It’s a place where inclusion, belonging, and overall well-being are prioritized, which is something I truly appreciate. What motivates me every day is knowing that I’m contributing to an environment where gratitude and positivity are part of how we work together. It feels great to be part of a team where people are supported, recognized, and encouraged to take care of their well-being. That sense of collaboration, mutual respect, and focus on well-being is what excites me about being here. ❓Edifecs is a demanding company. How do you create work/life harmony? How do you decompress after work? Creating work/life harmony is essential to maintaining a positive mindset, and I make it a priority to find balance. Outside of work, I love spending quality time with friends and family. I also practice hot yoga, which helps me unwind and focus on my physical and mental well-being. These activities help me recharge and ensure that I return to work feeling refreshed and ready to contribute to the positive, inclusive culture here at Edifecs. ❓What's one thing that few of your co-workers know about you? One thing most of my coworkers probably don’t know is that I’m really into baking, especially sourdough. It’s a hobby I find super relaxing and fun—it’s like a little creative project for me outside of work. I love watching the dough come to life and sharing my creations with friends and family! 🌟Join us in honoring the #womenofedifecs achievements, resilience, and contributions to the workplace and beyond. Stay tuned for inspiring profiles all month long! ✨ #NationalWomensMonth #WomenInTech

We’re teaming up with Accenture TOMORROW to talk about current interoperability challenges, plus, new consent management solutions that are allowing health plans to stay compliant. There’s still time to register—sign up now: https://lnkd.in/ePs_2cwB #interoperability #healthcareIT #healthplans #healthtech #payers

This Women’s History Month, we’re shining a spotlight on the incredible women who make Edifecs a great place to work. Throughout March, we’ll be sharing their stories, motivations, and insights as part of our #WomenOfEdifecs series. Our series continues with Betty Stump, Sr. Solution Consultant. ❓ Share the best advice you’ve ever received: Two pieces of advice have stuck with me throughout my career. First, when I was young, I worked in my grandfather’s medical office, and his office manager repeatedly corrected me for saying, “I’m afraid…” when delivering bad news. She would ask, “What are you so afraid of?” That lesson stuck with me—I haven’t used that phrase in 40 years! The second, and most impactful, was to always trust my personal ‘North Star’ when making career decisions. This advice has guided me to take on roles that align with my values and aspirations. Looking back, I can see how every decision I made stayed true to my ethical beliefs and passion for healthcare. ❓ Why are you passionate about Edifecs? What motivates you every day? I truly believe in the program I support and the work Edifecs does to advance risk adjustment through technology. At its core, risk adjustment helps healthcare providers better understand patient health, manage care appropriately, and improve outcomes—it’s about more than just revenue. Our solutions empower healthcare organizations to capture disease burden effectively and drive value-based care. That mission keeps me motivated every day. ❓ Edifecs is a demanding company. How do you create work/life harmony? How do you decompress after work? Having worked remotely for over 20 years, I learned early on how to separate work and personal life—a challenge when your home is also your office! I’ve found that physically shutting my office door at the end of the day helps me mentally switch off. I also make sure to surround myself with friends from various professions to keep perspective. But my favorite way to decompress? Powering down my laptop, shutting the office door, and taking my miniature long-haired dachshund for a walk. It’s my daily reminder to shift from work mode to personal time. 🌟Join us in honoring the #womenofedifecs achievements, resilience, and contributions to the workplace and beyond. Stay tuned for inspiring profiles all month long! ✨ #NationalWomensMonth #WomenInTech