Healthcare EDI Market is Expected to Grow Drastically, Assured By Experts From 2023 To 2030 | Optum Inc., Dell Technologies Inc., General Electric Company

Healthcare EDI Market by Delivery Mode (Mobile EDI, EDI VAN, Web & Cloud-based EDI, and Point-to-Point EDI), by Component (Services and Solutions), by Transaction Type (Healthcare Supply Chain and Claims Management), by End User (Healthcare Payers, Healthcare Providers, Medical Device & Pharmaceutical Industries, and Pharmacies), and by region – Share, Outlook, Size, and Opportunity Analysis, 2022–2028

Efficient data management is crucial in the healthcare sector, as patient history and medical records play a significant role in medical claims and reimbursements. Electronic Data Interchange (EDI) serves as the software interface for exchanging data between different healthcare providers and payers using computer systems. By utilizing the EDI service, healthcare providers can process and track claims throughout the billing cycle.

To tackle the problems of lowering healthcare expenses and substituting paper-based exchanges with electronic ones, the healthcare sector looked into EDI. Additionally, government mandates like the Health Insurance Portability Act of 1996 (HIPAA) established norms to simplify administration in the healthcare domain.

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The growth of the healthcare EDI market is primarily driven by the advantages that EDI offers over traditional methods of data interchange. These benefits include improved accuracy, decreased data entry time, reduced rework, and lower operational costs. These essential features of EDI software help support the expansion of the healthcare EDI market.

Market Dynamics

The healthcare EDI market is experiencing growth due to the increasing digitization and transition towards paperless offices. In the past, data transfer relied heavily on paper-based communication, which resulted in a higher likelihood of human errors and complicated workflows. Therefore, EDI has become an indispensable tool for achieving administrative efficiencies, reducing time, and generating substantial cost savings.

The growth of the healthcare EDI market is driven by the rising usage of EDI services to enhance the financial performance and profitability of healthcare payers and providers. GE Healthcare’s Centricity EDI Service is a prime example, with over 2,100 healthcare providers utilizing the service to handle roughly 588 million transactions each year. EDI is implemented to decrease the likelihood of claim rejection and denial, as well as to shorten the time required for submitting and processing claims.

In addition, EDI plays a crucial role in the simplification of the healthcare reimbursement process for payers, as well as in the documentation of insurance claims. Nevertheless, the healthcare EDI market growth is anticipated to be impeded during the projected timeframe due to the considerable expenses associated with the application and utilization of EDI software.

Regional Analysis

Coherent Market Insights has segmented the healthcare EDI market regionally, covering Africa, Latin America, Asia Pacific, North America, Europe, and the Middle East. Among these regions, the North American healthcare EDI market currently holds the most dominant position globally due to its advanced healthcare infrastructure. Additionally, the adoption of cutting-edge technologies aimed at enhancing healthcare facilities is expected to further drive growth in the regional healthcare EDI market. On the other hand, the Asia Pacific healthcare EDI market is poised to grow at the fastest rate due to the region’s improving healthcare infrastructure, which presents an attractive market opportunity for industry participants looking to expand their reach in this market.

Competitive landscape

Some of the prominent players leading the healthcare EDI market are The SSI Group, LLC, Tallan, Inc., Optum Inc., Emdeon Inc., Allscripts Healthcare Solutions Inc., Dell Technologies Inc., ZirMed, Inc., General Electric Company, and Quadax.

The players in the healthcare EDI market have a strong focus on enhancing EDI services through the implementation of diverse strategies. In 2015, Medical Transcription Billing, Corp., which is a healthcare information technology firm, acquired three departments of QHR Corporation, a healthcare technology firm based in Canada. QHR Corporation specializes in healthcare clearinghouse, Electronic Data Interchange (EDI), and revenue cycle management divisions.

Furthermore, in 2016, Tallan Inc. merged with the Dell Boomi Platform to improve the high data throughput of its T-connect extensible framework and keep up with the constantly evolving EDI requirements. During the same year, Optum Inc. collaborated with Availity, a healthcare information Technology Company, to enhance the precision of health insurance claims and minimize errors.

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Classification of the healthcare EDI market

Based on the type of component:

• Services
• Solutions

Based on the type of delivery mode:

• Mobile EDI
• EDI VAN
• Web-based & cloud-based EDI
• Point-to-Point EDI

Based on the type of transaction:

• Claims Management
• Claims Status
• Healthcare supply chain
• Claim Submission
• Payment Remittance
• Eligibility Verification
• Claim Payments
• Referral Certification and Authorization
• Others

Based on the type of end user:

• Healthcare Payers
• Pharmacies
• Healthcare Providers
• Medical Device and Pharmaceutical Industries

Based on the type of geographical region:

• Africa
• Latin America
• Asia Pacific
• North America
• Europe
• Middle East

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Table of Contents with Major Points:

Executive Summary

• Introduction
• Key Findings
• Recommendations
• Definitions and Assumptions

Market Overview

• Definition of Healthcare EDI Market
• Market Dynamics
• Drivers
• Restraints
• Opportunities
• Trends and Developments

Key Insights

• Key Emerging Trends
• Key Developments Mergers and Acquisition
• New Product Launches and Collaboration
• Partnership and Joint Venture
• Latest Technological Advancements
• Insights on Regulatory Scenario
• Porters Five Forces Analysis

Qualitative Insights Impact of COVID-19 on Global Healthcare EDI Market

• Supply Chain Challenges
• Steps taken by Government/Companies to overcome this impact
• Potential opportunities due to COVID-19 outbreak

Conclusion 

Appendix

• Data Sources
• Abbreviations
• Disclaimer

TOC Continued…!

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