Healthcare EDI Market Set for Rapid Growth and Trend, by 2026

Healthcare EDI Market Value Projected
to Expand by 2018- 2026
Healthcare EDI Market by Component (Services and Solutions), by
Delivery Mode (Web & Cloud-based EDI, EDI VAN, Point-to-Point EDI,
and Mobile EDI), by Transaction Type (Claims Management and
Healthcare Supply Chain), by End User (Healthcare Providers,
Healthcare Payers, Medical Device & Pharmaceutical Industries, and
Pharmacies), and by Region - Size, Share, Outlook and Opportunity
Analysis 2018 - 2026
Healthcare domain has critical importance of the data management, as medical records and patient
history play significant role in medical claims and reimbursement. Electronic Data Interchange (EDI) is
the software medium for transaction of data among various healthcare providers and payers via
computer systems. Organizer can process and track claims through the entire billing cycle via EDI
service. The healthcare industry explored EDI to address the challenges of reducing healthcare cost and
replacing paper-based transaction with standard electronic transaction. Moreover, government acts such
as Health Insurance Portability Act of 1996 (HIPAA) created standards to achieve administrative
simplicity in healthcare industry.
The benefits of EDI over conventional method of data interchange is the major factor driving the
healthcare EDI market growth. EDI reduces data entry time, improves accuracy, reduce operational
cost, and also reduce the rework. Such key features of EDI software supports the growth of healthcare
EDI market.
Healthcare EDI Market Dynamics
Increasing digitization and paperless office is enhancing the growth of healthcare EDI market.
Conventionally, data transfer was subjected to paper-based communication, increasing the chance of
human error and making the workflow cumbersome. Henceforth, EDI is an essential component for
creating administrative efficiencies by reducing time and significant cost saving.
Healthcare EDI market is propelled by increasing adoption of EDI facilities in order to accelerate
financial performance and profitability for healthcare payers and providers. For instance, according to
GE Healthcare, the Centricity EDI Service of GE Healthcare employs more than 2,100 healthcare
providers to manage around 588 million transaction annually. EDI is adopted to reduce the claim
rejection and denials as well as reduce time requirement for submission and remission of claims.
Healthcare EDI Market - Taxonomy
On the basis of component, the healthcare EDI market is segmented into:
• Services
• Solutions
On the basis of delivery mode, the healthcare EDI market is segmented into:
• Web & Cloud-based EDI
• EDI VAN
• Point-to-Point EDI
• Mobile EDI
On the basis of transaction type, the healthcare EDI market is segmented into:
• Claims Management
• Claims Submission
• Claim Status
• Eligibility Verification
• Payment Remittance
• Referral Certification & Authorization
• Claim Payments
• Others
• Healthcare Supply Chain
On the basis of end user, the healthcare EDI market is segmented into:
• Healthcare Providers
• Healthcare Payers
• Medical Device & Pharmaceutical Industries
• Pharmacies
Healthcare EDI Market – Competitive Analysis
Healthcare EDI market is dominated by the few major players such as Optum Inc., Dell Technologies
Inc., General Electric Company, Emdeon Inc., The SSI Group, LLC, ZirMed, Inc., Tallan, Inc.,
Quadax, and Allscripts Healthcare Solutions Inc.
The market player involved in healthcare EDI market are focused on improving the EDI facilities by
using various strategies. For instance, in 2015, Medical Transcription Billing, Corp., a healthcare
information technology company, acquired three divisions of QHR Corporation, Canada-based
healthcare technology company. The QHR Corporation is involved in healthcare clearinghouse,
Electronic Data Interchange (EDI), and revenue cycle management divisions.
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Healthcare EDI Market - Regional Analysis
Regional segmentation of healthcare EDI market by Coherent Market Insights include North America,
Latin America, Europe, Asia Pacific, Middle East, and Africa. North America healthcare EDI market
holds dominant position in the global healthcare EDI market, owing to the dominant position is the
advanced healthcare infrastructure of the region. Moreover, increasing adoption of technologically
advanced facilities to improve the healthcare facilities are expected to boost the regional healthcare
EDI market growth. However, Asia Pacific healthcare EDI market is expected to witness fastest growth
attributed to improving healthcare infrastructure in the region, thereby providing the market
opportunity for the market players to penetrate in Asia Pacific region.
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Healthcare domain has critical importance of the data management, as medical records and patient history play significant role in medical claims and reimbursement. Electronic Data Interchange (EDI) is the software medium for transaction of data among various healthcare providers and payers via computer systems. Organizer can process and track claims through the entire billing cycle via EDI service. The healthcare industry explored EDI to address the challenges of reducing healthcare cost and replacing paper-based transaction with standard electronic transaction.

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