EDI Gateway

Modernize infrastructure. Automate operations.
Accelerate innovation.

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EDI Gateway is part of Cotiviti's Interoperability solution suite.

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96%

of surveyed Payment Integrity VPs, Directors and Managers at payer organizations are likely to recommend Cotiviti.*

Many healthcare organizations manage their data with aging, on-premises solutions. Maintaining these solutions often comes at a cost: internal resource strain due to legacy infrastructure maintenance, mounting technical debt, insufficient scalability, and greater potential for data security risks and cascading failures.


Read the EDI Gateway Fact Sheet

Cotiviti’s EDI Gateway solution is here to help.

Our fully-managed EDI Gateway ingests data in various formats from multiple organizations and transforms it into standardized, X12 HIPAA-compliant transactions. With the EDI Gateway, health plans can improve the quality and completeness of information exchanged with internal and external trading partners, optimize workflows, capture key business insights, and easily track performance against SLAs. Our fully-managed model also allows for continuous updates alongside evergreen compliance enhancements to not only reduce your IT costs but create value by unlocking new capabilities and supporting decision making.

Shift from operational complexity to innovation

The EDI Gateway enables healthcare organizations to harness data, act sooner, and improve trading partner relationships.

Configure workflow and escalations, ensure consistent data quality, and automate alerts. Track SLAs with alerts, spot trends with in-depth reporting, and determine the cause of rejections to quickly correct transactions. Deliver business-friendly insights to non-technical team members, support performance management with partner and channel activity trends, and grow potential trading partners with non-standard transaction exchange support.

Lower operational costs and improve service with the EDI Gateway

EDI Gateway

EDI Gateway supported outcomes

  • Improve first-pass rates with the same EDI validation and integration engine used in CMS’ Administrative Simplification Enforcement and Testing Tool (ASETT)
  • Limit audit exposure with searchable and HIPAA-compliant records of current and archived transactions
  • Significantly decrease costs associated with managing changes to program code sets and guidelines
  • Reduce manual workflows with automated monitoring and integrated transaction correction capabilities
  • Avoid costly errors with self-service access to troubleshooting and issue detection for staff and partners

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