# Edifecs

> Edifecs is a Bellevue-founded healthcare software business, acquired by Cotiviti in March 2025, that helps health plans, health systems and government programs exchange and validate data, automate administrative workflows and administer value-based payments. Its expertise sits between healthcare transaction standards and the operational systems that use them.

- **Founded:** 1996
- **Headquarters:** Bellevue, United States
- **Founders:** Gurpreet “Sunny” Singh (Founder and former CEO)
- **Products:** Smart Trading, SpecBuilder, EDI Gateway, FHIR Gateway / Interoperability Gateway, Consent Management
- **Notable:** 2026 Best in KLAS for CMS Payer Interoperability; reported overall score 91.9., Also recognized in the same KLAS category in 2023 and 2024., Grew from general-purpose EDI tools into healthcare transaction processing and business applications.

## Products & services

- **Smart Trading** — Modular healthcare data-exchange suite incorporating SpecBuilder, XEngine Server and Transaction Management.
- **SpecBuilder** — Toolkit for authoring, testing and publishing transaction specifications and maps; founder dates the original tool to 1996.
- **EDI Gateway** — Processes and validates real-time and batch healthcare transactions and connects downstream systems.
- **FHIR Gateway / Interoperability Gateway** — Connects FHIR APIs with legacy healthcare exchange standards, including EDI and HL7.
- **Consent Management** — Captures member preferences and manages policies governing data sharing.
- **Prior Authorization** — Ingests, standardizes and routes authorization information arriving through multiple channels.
- **Population Payment Management** — Manages alternative-payment contracts, populations, payment streams and settlements; a September 2025 update introduced Virtual Jonathan, Dashboard Agent and Deep Research Agent.
- **Enrollment Management** — Automates health-plan enrollment data handling and onboarding workflows.

## Achievements

- 2026 Best in KLAS for CMS Payer Interoperability; reported overall score 91.9.
- Also recognized in the same KLAS category in 2023 and 2024.
- Grew from general-purpose EDI tools into healthcare transaction processing and business applications.
- Acquired by Cotiviti on March 31, 2025.

## Latest updates

- **2026-10** — Website observed October 17, 2026 states “Edifecs is now Cotiviti” and redirects visitors to Cotiviti; observation date, not a claimed launch date.
- **2026-02** — Named 2026 Best in KLAS for CMS Payer Interoperability.
- **2025-09** — Announced agentic AI additions to Population Payment Management.
- **2025-03** — Cotiviti completed acquisition of Edifecs.

## Links

- Website: https://www.edifecs.com/
- LinkedIn: https://www.linkedin.com/company/edifecs/
- Twitter/X: https://x.com/edifecs
- YouTube: https://www.youtube.com/@Cotiviti
- Facebook: https://www.facebook.com/CotivitiInc/

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Profile page: https://yespress.io/edifecs
Published by YesPress — https://yespress.io
Last updated: 2026-10-17