HealthTech Firm Edifecs to Buy Risk Adjuster Health Fidelity

Edifecs, a health information tech solutions company, has bought risk adjustment solution provider Health Fidelity, a press release says.

The company also recently bought Talix, a risk adjustment solution provider itself.

Edifecs plans to implement Health Fidelity and Talix into its signature Encounter Management solution, giving customers the ability to do more efficient risk adjustment for things like Medicare Advantage, Managed Medicaid, and Affordable Care Act (ACA) products.

Health Fidelity’s service aids in risk-adjustment challenges like visibility and control over the processes. The tech “uncovers insights” to help out with things like care planning and revenue capture.

Edifecs’ integration of Health Fidelity will offer better natural language processing (NLP), workflow and submissions solutions. It will also offer more financial analytics, and the solution will get done seamlessly without customers having to pay for integrations or a multi-vendor management overhead.

“Traditional risk adjustment solutions have rapidly outgrown their retrospective-only payer use cases,” said Venkat Kavarthapu, CEO of Edifecs. “By combining Health Fidelity and Talix solutions with our own workflow, Edifecs can now offer payers and providers clinical and coding solutions that deliver risk adjustment insights across many operational areas all while enabling the shift to value-based care.”

Health Fidelity CEO Steve Whitehurst said the company would “provide our customers access to Edifecs’ industry-leading solutions, services, and support.”

“As we evaluated our future strategy, the decision to join Edifecs was an easy one,” he said. “Their technology is unmatched and their passionate commitment to customer success aligns with our company values and our future goals.”

PYMNTS writes that telehealth has been gaining traction over the pandemic, with more options for digital payments. Patients, who are now more aware of their financial responsibility, have been looking into better experiences.

Read more: Telehealth, Digital Payments Make Healthcare Easier, Affordable for Patients and Providers

Shannon Burke, Synchrony’s senior vice president and general manager of health systems, said consumers see advancements in the ways telehealth and digital payments have combined. They want more, Burke said.