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This is MedImpact Story

MedImpact is the nation’s largest privately held pharmacy benefit manager (PBM) serving health plans, self-funded employers, and government entities. In operation for 30 years, its goal is to provide flexible solutions and membercentric products with a focus on lowest-net cost and quality outcomes. With a significant presence in the California managed Medicaid (MCO) market, MedImpact is required to submit pharmacy encounter files to the state on behalf of its MCO clients. With this requirement in place, MedImpact identified a need to provide clients with a comprehensive encounter lifecycle management solution capable of driving compliance in the face of constant regulatory change and ensuring that MedImpact remained the PBM partner of choice in California and multiple other states. This is the MedImpact story

Successful encounter submission (and eventual reconciliation) is mission-critical for PBMs and managed care plans alike. Participating in multiple managed Medicaid states increases compliance complexity 10X. With the Edifecs Encounter Management solution, MedImpact can equip its clients with a comprehensive pharmacy encounter management solution that achieves high degrees of accuracy, completeness and timeliness and will further establish the organization as ‘best in class’ in terms of its respective states’ overall acceptance rate for pharmacy encounters.

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Edifecs Inc. is a global healthcare software company committed to improving outcomes, reducing costs, and elevating the value of healthcare for everyone. Edifecs delivers the industry’s premier IT partnership platform to providers, insurers, pharmacy benefit management companies, and other trading partners. By mobilizing its leading solutions at the front end of the healthcare information pipeline, Edifecs provides a unified platform for partners to flexibly pilot and scale new initiatives using their existing enterprise systems. Since 1996, hundreds of healthcare customers have relied on Edifecs partnership solutions to future-proof their leading initiatives in the midst of a dynamic healthcare landscape. Edifecs is based in Bellevue, WA, with operations internationally. Learn more about us at edifecs.com.

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