Edifecs Named 2026 Best in KLAS® for CMS Payer Interoperability

KLAS recognition affirms Edifecs’ reliability and performance as interoperability becomes mission-critical for payers

SALT LAKE CITY--(BUSINESS WIRE)--Edifecs, a Cotiviti business and a pioneer in healthcare data and interoperability, has been named the 2026 Best in KLAS^® for CMS Payer Interoperability by KLAS Research. This ranking, included in the 2026 Best in KLAS: Software & Services report, highlights Edifecs’ leadership in delivering proven, reliable interoperability solutions at a pivotal moment for the healthcare industry. The designation is based on extensive feedback from payer organizations evaluating vendors’ ability to meet the Centers for Medicare & Medicaid Services (CMS) interoperability requirements at scale while delivering strong customer experience, execution, and long-term value.

“Payers are urgently working to comply with evolving interoperability mandates and seeking proven solutions that support compliance while delivering operational reliability and strong business value,” said Emad Rizk, M.D., chairman, president and CEO of Cotiviti. “Edifecs’ Best in KLAS recognition reinforces that reliable interoperability software is a powerful tool in combating the billions of dollars lost to inefficiency, waste and avoidable errors. Together, the Edifecs and Cotiviti portfolio empowers healthcare stakeholders to activate their data at the right time to reduce medical and administrative spending for better outcomes across payment integrity, risk adjustment, quality improvement, and member engagement.”

Edifecs’ Best in KLAS recognition comes as payers face a January 1, 2027 deadline to comply with the API implementation requirements of the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). The rule is designed to improve access to health information, accelerate prior authorization, enhance care coordination, and reduce administrative burden across the healthcare ecosystem.

Edifecs earned the highest overall performance score, 91.9, and the highest rating across multiple KLAS customer experience pillars, including loyalty, culture, product, and relationship, reinforcing its reputation as a trusted, long-standing partner in interoperability. This marks the third time in the past four years that Edifecs has been recognized by KLAS for CMS Payer Interoperability, with prior recognitions in 2023 and 2024.

“This Best in KLAS recognition underscores Edifecs’ deep roots in the market and our sustained ability to deliver at scale as regulatory and operational demands continue to rise,” said Venkat Kavarthapu, executive vice president of Edifecs Operations for Cotiviti. “We are honored to be recognized by our customers as the industry-leading partner for interoperability.”

Edifecs’ Best in KLAS recognition reflects strong customer feedback on Interoperability Gateway (XEngine Server for FHIR), the solution measured in the CMS Payer Interoperability category. Interoperability Gateway is part of a broader interoperability software portfolio designed to support CMS-0057-F requirements, reduce administrative costs, and support strategic interoperability. This suite includes:

• EDI Gateway, which enables high-quality, consistent, and HIPAA-compliant data exchange across all systems and formats
• FHIR Gateway, which modernizes and streamlines data exchange by bridging FHIR with legacy standards like EDI and HL7 and consolidates all APIs into a single, flexible platform
• Consent Management, which captures member consent preferences and enables simple, effective management of data-sharing policies for continuous compliance with state and federal regulations
• Prior Authorization, which delivers automatic and real-time ingestion, standardization, routing, and orchestration of all prior authorization formats, including fax, EDI, FHIR, and portals

“The Best in KLAS awards recognize the vendors who consistently deliver excellence through partnership with healthcare organizations,” said Adam Gale, CEO of KLAS Research. “Winning this award means customers trust you to help them succeed in our rapidly changing healthcare landscape. This means helping them to improve patient care, achieve better outcomes, and find true ROI. We’re honored to amplify the voice of providers and payers at KLAS, and to celebrate those vendors who turn feedback into action.”

This recognition is also the result of Edifecs’ commitment to the creation and adoption of interoperability standards. The company is an active participant in working groups within HL7 Fast Healthcare Interoperability Resources (FHIR), The Sequoia Project, and WEDI, and a founding member of the HL7 Da Vinci Project Interoperability Standards Group that focuses on the adoption of HL7 FHIR standards. CMS uses the Edifecs Onboarding & Testing Cloud Service (OTCS) platform as part of its administrative simplification testing tool (ASETT). Edifecs is also a CAQH CORE-authorized testing vendor that has provided CORE certification testing services since 2006.

A summary of the KLAS findings and additional insights on Edifecs’ interoperability solutions are available at this link.

About Edifecs
Edifecs, a Cotiviti business, provides market-leading technology to enable its payer and health system customers to unlock greater value with their healthcare operations solutions and data management platform, which includes its award-winning healthcare interoperability cloud solution. Edifecs healthcare SaaS solutions serve as the foundation that eliminates stakeholder friction to overcome healthcare’s biggest challenges, including accelerating value-based care adoption and obtaining more complete and accurate care funding. For more information, visit www.edifecs.com.

About Cotiviti
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. Cotiviti’s solutions increase transparency and collaboration between payers and providers while empowering them to reduce medical and administrative costs, enable better health, improve claims payment efficiency, streamline operations, drive interoperability, and advance value-based care. Its customers serve the majority of U.S. healthcare consumers, providing coverage and care for over 300 million members and patients. Additionally, Cotiviti offers data management and recovery audit services to the retail sector to improve business outcomes. For more information, visit www.cotiviti.com.

About KLAS Research
KLAS is a research and insights firm on a global mission to improve healthcare. Working with thousands of healthcare professionals and clinicians, KLAS gathers data and insights on software and services to deliver timely reports and performance data that represent provider and payer voices and act as catalysts for improving vendor performance. The KLAS research team publishes reports covering the most pressing questions facing healthcare technology today, including emerging technology insights, that provide early insights on the future of healthcare technology solutions. KLAS also fosters measurement and collaboration between healthcare providers and payers and best practice adoption. Learn more at KLASresearch.com.