Exchange EDI
- Company typePrivate
- Founded2009
- HeadquartersTallahassee, United States
- Headcount11–50
- GTM typeB2B
- OfferingSoftware
Exchange EDI firmographics
Firmographics- Name
- Exchange EDI
- Legal name
- Technology Partners, LLC
- Website
- https://exchangeedi.com
- Company type
- Private
- Founded year
- 2009
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Ownership category
- akta.pro rank
Exchange EDI industry classification
Industry- Product category
- Healthcare Revenue Cycle Management Software
- NAICS
- Custom Computer Programming Services (541511)
- SIC
- Services-Prepackaged Software (7372), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)
- akta.pro secondary industries
- Medical Billing & Coding Automation (HLACACAA), B2B/EDI & Supply Chain Process Automation Platforms (HDAEAHAK)
Keywords
Where Exchange EDI is headquartered
LocationHeadquarters
- HQ city
- Tallahassee
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Exchange EDI business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Marketing or Sales, Infrastructure, Operations
Revenue model
- Software Subscription / Licensing: Exchange EDI appears to generate revenue through subscription-based software licensing of its prior authorization, patient estimation, and payment portal platforms to healthcare provider organizations (physicians, hospitals, health systems). The Direct Quote Payments Gateway is described as a virtual payment terminal replacement, suggesting a recurring SaaS/fee model. No public pricing is disclosed.
- BPO / Managed Services: Exchange EDI offers a Business Process Outsourcing (BPO) service for prior authorization where the Exchange EDI team manages the full authorization workflow on behalf of the customer, suggesting a per-transaction or per-request managed services fee.
- Payment Processing / Transaction Fees: The Direct Quote Payments Gateway processes credit card and ACH payments for healthcare offices, likely generating transaction-based fees per payment processed. The system supports card-on-file and recurring payment plans.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Quote-based enterprise pricing for healthcare providers |
Go-to-market motion1 record
Distribution channels5 records
Marketing channels4 records
Exchange EDI product offering
Product offeringCore offering
Exchange EDI provides an integrated cloud-based healthcare revenue cycle automation platform that combines prior authorization automation, real-time patient liability estimation, and an online patient payment portal. The platform connects to scheduling, practice management (PM), and EMR/HIS systems via HL7/API, automatically submits and tracks authorizations with payers, calculates patient responsibility at the point of service, and processes payments through a HIPAA-compliant gateway with auto-posting back into existing systems. The company also offers Business Process Outsourcing (BPO) services to manage the prior authorization workflow on behalf of customers.
Product overview
Exchange EDI offers a unified healthcare revenue cycle management platform with three core products: Prior Authorization Software for automating authorization validation and acquisition, Patient Estimation / Direct Quote 2.0 for real-time patient liability calculation and payment processing, and Patient Portal for online bill pay and payment plans. These products share integrated API/HL7 connectivity to Practice Management Systems, enabling bi-directional data flow with auto-posting of transactions. Supporting capabilities include the Direct Quote Payments Gateway (a HIPAA-compliant payment processor) and an internally developed Rules Engine for customizing payer eligibility responses. The company also offers BPO Services as a managed option for prior authorization processing.
Differentiator
Problem solved
Functional benefit
Brands
- Direct Quote 2.0: Patient Estimation Software providing real-time estimates for patient liability based on procedure, co-pay, co-insurance, and remaining deductible.
- Direct Quote Payments Gateway
Products and services
- Prior Authorization Software Automated prior authorization software that manages validation and acquisition of authorizations for physicians, hospitals, and health systems through an intuitive dashboard. Automatically verifies authorization numbers, submits requests to payers, monitors status, and returns approval numbers with valid date ranges.
- Patient Estimation / Direct Quote 2.0 Real-time patient liability estimation software that calculates patient responsibility based on procedure, co-pay, co-insurance, and remaining deductible. Includes a cloud-based Rules Engine for customizing eligibility responses and a HIPAA-compliant payment gateway for credit card and ACH transactions.
- Patient Portal Online patient payment portal offering 24/7 remote access for bill payment, payment plans, and e-Bill Presentment. Features auto-notifications via text or email, accepts credit cards and ACH, and integrates with facility HIS/PM systems for seamless data flow.
- Direct Quote Payments Gateway HIPAA/HITECH/PCI-compliant virtual payment terminal designed for healthcare offices that processes credit/debit cards and ACH transactions. Supports multiple locations from a single portal, maintains card-on-file for recurring payments, and generates transaction reports that auto-post to PMS/HIS systems.
- Exchange EDI BPO Services Business Process Outsourcing service where the Exchange EDI team handles the entire prior authorization workflow on behalf of the customer using Direct Prior Authorization Provider portal technology as a stand-alone tool.
Quantifiable outcome
- Significant reduction in labor efforts and dramatic increase in cash collections upfront for radiology practice
- +4 more outcomes
Companies that use Exchange EDI
Customer profileNamed customers1 record
Segments2 records
Ideal customer profiles2 records
Exchange EDI technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration5 records
AI capability2 records
Feature9 records
Exchange EDI partnerships and signals
Strategic signalPartnerships
Four partnerships are on record, tiered core and minor.
- API / HL7 Integration PartnerscoreExchange EDI enables technology integration through API, HL7, embedded IFrame, and CSV connectivity, allowing vendor partners to connect Exchange EDI's authorization and payment capabilities into their scheduling, practice management, and EMR/HIS systems.
- ISO PartnerscoreIndependent Sales Organizations (ISOs) resell Exchange EDI's prior authorization, patient estimation, and payment portal solutions to healthcare provider organizations across the United States as part of a formal channel sales program.
- Referral Program PartnersminorPartners in a referral program direct potential healthcare provider customers to Exchange EDI's products in exchange for referral compensation, expanding customer acquisition reach without direct sales involvement.
- Consultant Program PartnersminorHealthcare technology consultants recommend Exchange EDI's revenue cycle automation solutions to their healthcare provider clients as part of a structured consultant partnership program.
Scale indicators1 record
Recent moves5 records
Expansion highlights6 records
Exchange EDI competitors and assessment
Company assessmentDirect peers
- Waystar: Waystar is a leading healthcare revenue cycle cloud platform offering prior authorization, patient estimation, and patient payment solutions to hospitals and physician practices. It directly competes with Exchange EDI across all three core product lines.
- Experian Health: Experian Health provides patient access solutions including eligibility verification, prior authorization, patient estimation, and payment processing to U.S. providers. It overlaps Exchange EDI's portfolio of payer-provider data exchange and patient estimation tools.
- Infinx: Infinx delivers AI-powered prior authorization and revenue cycle management solutions to hospitals, health systems, and physician practices. It competes head-to-head with Exchange EDI's prior authorization automation and BPO services.
- Availity: Availity operates a payer-provider data exchange network for eligibility, prior authorization, claims, and clinical attachment transactions. It directly overlaps Exchange EDI's EDI-based payer-provider interoperability offering.
- Phreesia: Phreesia offers a patient intake platform with eligibility verification, patient responsibility estimation, and online bill pay for medical groups and health systems. It overlaps Exchange EDI's patient estimation and payment portal products.
- Cedar: Cedar provides a patient billing and engagement platform combining personalized estimates, digital intake, and payment processing for healthcare providers. It directly competes with Exchange EDI's Patient Portal and Direct Quote Payments Gateway.
- Health iPASS: Health iPASS provides patient estimation, check-in, and payment processing solutions for medical practices, mirroring Exchange EDI's Direct Quote 2.0 and Patient Portal offerings to the same physician and specialty practice segment.
Emerging players
- AKASA: AKASA builds AI-driven revenue cycle automation for hospitals and health systems covering prior authorization, claims, and denials. It targets a similar provider buyer to Exchange EDI but with a more automation-led, AI-native architecture.
Others
- ImagineSoftware: ImagineSoftware is a sister company under the same parent (Technology Partners, LLC), providing broader medical billing and RCM software to hospitals and physician practices. It is technically an affiliated brand rather than a competitor, and represents an internal cross-sell channel for Exchange EDI.
Broad incumbents
- Optum (Change Healthcare): Optum, through its acquisition of Change Healthcare, offers an expansive revenue cycle management suite including eligibility, prior authorization, estimation, and payments to providers nationwide. It is a broad incumbent that overshadows Exchange EDI in enterprise accounts while indirectly shaping pricing across the segment.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights7 records
Customer concentration
Exchange EDI social profiles
Digital presenceExchange EDI compliance and trust
Trust signalCompliance2 records
Exchange EDI financial estimates
Financial estimateRevenue estimate
Valuation estimate
Exchange EDI leadership team
Management profileNumber of profiles
Exchange EDI funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Exchange EDI M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Exchange EDI
What does Exchange EDI do?
Exchange EDI provides an integrated cloud-based healthcare revenue cycle automation platform that combines prior authorization automation, real-time patient liability estimation, and an online patient payment portal. The platform connects to scheduling, practice management (PM), and EMR/HIS systems via HL7/API, automatically submits and tracks authorizations with payers, calculates patient responsibility at the point of service, and processes payments through a HIPAA-compliant gateway with auto-posting back into existing systems. The company also offers Business Process Outsourcing (BPO) services to manage the prior authorization workflow on behalf of customers.
Is Exchange EDI a public or private company?
Exchange EDI is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Exchange EDI founded?
Exchange EDI was founded in 2009. It employs 11 to 50 people.
Where is Exchange EDI based?
Exchange EDI is headquartered in Tallahassee, United States, in the North America region.
How does Exchange EDI make money?
Three revenue lines are on record. Software Subscription / Licensing is the primary driver. The others are BPO / Managed Services and payment Processing / Transaction Fees.
Who are Exchange EDI's main competitors?
Direct peers on record are Waystar, Experian Health, Infinx, Availity, Phreesia, Cedar and Health iPASS. AKASA is listed as an emerging player. ImagineSoftware is listed as an others. Optum (Change Healthcare) is listed as a broad incumbent.
Does Exchange EDI have an API?
Yes. Exchange EDI offers API integration as a vendor integration option for connecting to their platform. The main platform features API/HL7 connectivity to scheduling solutions. The API enables integration with Practice Management Systems (PMS) and HIS systems, allowing bi-directional data flow for prior authorization, patient eligibility verification, and patient estimation workflows.
What industry is Exchange EDI in?
Exchange EDI's product category is Healthcare Revenue Cycle Management Software. Its primary akta.pro industry code is HLACABAK, Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment), with a secondary code of HLACACAA, Medical Billing & Coding Automation. Its NAICS code is 541511 and its SIC code is 7372.