eMedix
eMedix, founded in 1990 and now a division of CompuGroup Medical US, provides a healthcare EDI and claims clearinghouse platform serving US health systems, physician practices, and medical billing services through a vendor-agnostic, single-login product suite spanning claims management, denial prevention, remittance, eligibility, and patient payments.
- Company typePrivate
- Founded1990
- HeadquartersColumbia, United States
- Headcount1–10
- GTM typeB2B
- OfferingSoftware
What eMedix does
eMedix is a healthcare Electronic Data Interchange (EDI) and claims clearinghouse platform, founded in 1990 and operating as a division of CompuGroup Medical US, which is in turn a wholly-owned subsidiary of publicly-traded German healthcare IT company CompuGroup Medical SE & Co. KGaA (Frankfurt: COP). The US parent entity, CompuGroup Medical, Inc., is headquartered in Richardson, Texas. eMedix targets US healthcare organizations across three primary segments: health systems and hospitals, physician and specialty practices (cardiology, orthopedics, OB/GYN, primary care, and others), and third-party medical billing services. The company is positioned as vendor-agnostic, integrating with any practice management or EHR system, and sells through a direct, sales-led motion with US-based implementation and support.
The core technology is a proprietary in-house claims clearinghouse engine that the company states achieves a 99.5% clean claims rate versus a 95% industry standard. Capabilities are delivered through the eMEDIX ONLINE single log-in web platform and span Claims Management, Revenue Resolve (denial prevention and recovery with automated prioritization via CORE Operating Rules), Electronic Remittance Management (24/7/365 ERA/835 processing with automatic claim attachment), real-time Eligibility Verification, Patient Responsibility Estimator, Patient Payments, EZ Enroll (online Medicaid/Medicare/Worker's Comp enrollment), and Reporting & Analytics. The platform is CAQH CORE Phase I (2020) and Phase II (2021) certified. Notable customer references include DuBois Regional Medical Center (acute care) and Behavioral Health Services Association (33 addiction service sites across South Carolina deployed in 2013).
Revenue is generated on a transaction-fee basis for claims processing, ERA handling, and related EDI services, supplemented by subscription-style access to the eMEDIX ONLINE platform and its modules. Pricing is quote-based and not publicly disclosed; the company cites a 95% client retention rate as evidence of recurring revenue durability. Go-to-market relies on direct enterprise sales, inside sales for mid-market practices and billing services, and content marketing, webinars, the annual CGM User Conference, case studies, and educational content distributed via CGM's US channels. Leadership for eMedix specifically includes VP of eMEDIX Niels Vildbrad (partnerships and business development) and VP R&D Rebecca Shealy (over 30 years of healthcare claims management experience).
eMedix firmographics
Firmographics- Name
- eMedix
- Legal name
- CompuGroup Medical, Inc.
- Website
- https://emedixus.com
- Company type
- Private
- Founded year
- 1990
- Operating status
- Operating
- Headcount range
- 1–10 employees
- Short description
- eMedix, founded in 1990 and now a division of CompuGroup Medical US, provides a healthcare EDI and claims clearinghouse platform serving US health systems, physician practices, and medical billing services through a vendor-agnostic, single-login product suite spanning claims management, denial prevention, remittance, eligibility, and patient payments.
- Ownership category
- akta.pro rank
eMedix industry classification
Industry- Product category
- Healthcare Claims Clearinghouse & Revenue Cycle Software
- NAICS
- Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (5182), Custom Computer Programming Services (541511), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518210)
- SIC
- Services-Computer Programming, Data Processing, Etc. (7370), Services-Health Services (8000)
- akta.pro primary industry
- Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)
- akta.pro secondary industry
- EHR Implementation, Optimization, Training & Managed Services (HLACAAAL)
Keywords
Where eMedix is headquartered
LocationHeadquarters
- HQ city
- Columbia
- HQ country
- United States
- HQ region
- North America
Offices4 records
Markets served
eMedix business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Operations, Marketing or Sales, Infrastructure
Revenue model
- Healthcare EDI & Claims Clearinghouse Services: eMEDIX generates revenue through its healthcare EDI and claims clearinghouse services, providing electronic claims submission, remittance management, eligibility verification, and denial management. The platform processes claims for healthcare providers, health systems, and billing services on a transaction basis, with revenue derived from per-transaction fees for claims processing, ERA handling, and related EDI services. The company has maintained a 95% client retention rate, indicating strong recurring revenue from existing customers.
- Software-as-a-Service Platform Access: Revenue cycle management software delivered via eMEDIX ONLINE single log-in platform, providing continuous access to billing intelligence, denial management, and reporting tools on a subscription or per-claim basis.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Transaction based/ take rate | Pay-as-you-go | Custom enterprise and practice pricing based on transaction volume |
Go-to-market motion1 record
Distribution channels2 records
Marketing channels6 records
eMedix product offering
Product offeringCore offering
eMedix is a healthcare Electronic Data Interchange (EDI) and claims clearinghouse brand of CompuGroup Medical US that submits, adjudicates, and reconciles electronic medical claims for US healthcare providers. Its offering combines a proprietary in-house clearinghouse engine and the eMEDIX ONLINE single log-in SaaS platform with integrated modules for claims management, denial prevention and recovery (Revenue Resolve), electronic remittance management, eligibility verification, patient responsibility estimation, patient payments, online payer enrollment (EZ Enroll), and reporting/analytics. The platform is sold to health systems, physician and specialty practices, and third-party medical billing services as a vendor-agnostic solution that integrates with any PM or EHR system.
Product overview
eMEDIX is a comprehensive healthcare EDI and claims clearinghouse platform offered by CompuGroup Medical (CGM). The core product provides healthcare organizations with clean claims submission, denial management, patient access, and provider enrollment capabilities through a single log-in platform called eMEDIX ONLINE. The platform consists of multiple integrated modules including Claims Management, Revenue Resolve (denial prevention), Reporting, Remittance Management, Eligibility Verification, Patient Responsibility Estimator, Patient Payments, and EZ Enroll. The solution delivers a 99.5% clean claims rate and supports real-time eligibility queries and electronic remittance processing through CAQH CORE certified infrastructure.
Differentiator
Problem solved
Functional benefit
Brands
- Revenue Resolve: Denial prevention and recovery solution that helps practices manage denied claims through automated prioritization, customizable workflows, and reporting features.
- EZ Enroll
- eMEDIX ONLINE
Products and services
- eMEDIX Healthcare EDI & Claims Clearinghouse Vendor-agnostic healthcare EDI and claims clearinghouse solution that delivers clean claims submission, denial management, patient access, and provider enrollment for US health systems, physician and specialty practices, and medical billing services. Powered by a proprietary in-house claims engine with a 99.5% first-pass clean claims rate, it is accessed through the eMEDIX ONLINE single log-in SaaS platform.
- eMEDIX ONLINE Platform Single log-in web-based SaaS platform providing healthcare customers with unified access to claims management, denial prevention and recovery, electronic remittance management, eligibility verification, patient payments, enrollment, and reporting/analytics dashboards.
- Revenue Resolve (Denial Prevention & Recovery) Denial management sub-brand for healthcare practices that automatically prioritizes denied claims using CORE Operating Rules Business Scenarios, provides ready-made appeal templates, customizable workflows, user-friendly dashboards, and twice-daily email alerts to recover revenue lost to denied or delayed claims.
- EZ Enroll (Online Payer Enrollment) Online enrollment platform that streamlines provider enrollment with Medicaid, Medicare, Worker's Comp, and other payers, reducing the manual effort required to credential providers.
Quantifiable outcome
- 99.5% first-pass clean claims rate (vs. industry best practice of 95%)
- +4 more outcomes
Companies that use eMedix
Customer profileNamed customers2 records
Segments3 records
Ideal customer profiles3 records
eMedix technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature8 records
eMedix partnerships and signals
Strategic signalPartnerships
One partnership is on record.
- Behavioral Health Services Association (BHSA)coreeMEDIX partnered with BHSA to provide revenue cycle management and claims clearinghouse services for 33 addiction service sites throughout South Carolina. BHSA represents the 33 local alcohol and drug abuse authorities designated by Act 301 of the 1973 Code of Laws of South Carolina. Implementation was completed in three waves beginning October 1, 2013, with eMEDIX collaborating with BHSA team and member agencies for seamless transition to higher efficiency in claims settlement and reimbursements. eMEDIX's ability to adapt to behavioral healthcare business model was cited as key benefit.
Scale indicators8 records
Recent moves6 records
Expansion highlights5 records
eMedix competitors and assessment
Company assessmentDirect peers
- Change Healthcare (Optum): Major clearinghouse and revenue cycle management vendor (now part of Optum/UnitedHealth Group) offering the same X12 EDI claims, ERA, eligibility, and denial management capabilities as eMEDIX at much larger transaction scale.
- QuadaX: Specialized X12 EDI clearinghouse and revenue cycle vendor with similar claims management, eligibility, and ERA capabilities positioned primarily for smaller practices and billing services.
- Availity: Largest US health care clearinghouse and payer-provider data exchange platform, directly competing with eMEDIX on claims submission, eligibility, and remittance management for providers and health systems.
- Office Ally: Direct clearinghouse competitor offering electronic claims submission, eligibility verification, and remittance management targeting small and mid-sized practices in the same SMB segment as eMEDIX.
- Waystar: Cloud-based revenue cycle management platform competing head-to-head with eMEDIX in claims management, denials, remittance, and patient payments for hospitals and physician practices.
- Experian Health: Healthcare RCM and clearinghouse vendor offering eligibility, claims management, denials, and patient access solutions directly overlapping with eMEDIX's product modules.
Emerging players
- Claim.MD: Smaller, rapidly growing clearinghouse competitor offering X12 claims, eligibility, ERA, and denial tools with a pay-as-you-go model directly comparable to eMEDIX's transaction-based pricing.
- Edifecs: Healthcare data interoperability and EDI management vendor specializing in X12 and FHIR-based payer-provider data exchange with technical overlap to eMEDIX's clearinghouse engine.
Broad incumbents
- Zelis (NaviNet): Payer-provider data exchange and payment integrity platform with broad provider-facing claims and remittance offerings comparable to eMEDIX's payer-provider interoperability stack.
- Trizetto (Cognizant): Long-established clearinghouse and RCM vendor with claims management, benefits administration, and value-based care capabilities overlapping eMEDIX's core clearinghouse scope.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights7 records
Customer concentration
eMedix social profiles
Digital presenceeMedix compliance and trust
Trust signalCompliance2 records
eMedix financial estimates
Financial estimateRevenue estimate
Valuation estimate
eMedix leadership team
Management profileNumber of profiles
Profiles3 records
eMedix funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
eMedix 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 eMedix
What does eMedix do?
eMedix is a healthcare Electronic Data Interchange (EDI) and claims clearinghouse brand of CompuGroup Medical US that submits, adjudicates, and reconciles electronic medical claims for US healthcare providers. Its offering combines a proprietary in-house clearinghouse engine and the eMEDIX ONLINE single log-in SaaS platform with integrated modules for claims management, denial prevention and recovery (Revenue Resolve), electronic remittance management, eligibility verification, patient responsibility estimation, patient payments, online payer enrollment (EZ Enroll), and reporting/analytics. The platform is sold to health systems, physician and specialty practices, and third-party medical billing services as a vendor-agnostic solution that integrates with any PM or EHR system.
Is eMedix a public or private company?
eMedix is a private company. It is classified as corporate owned and is currently operating.
When was eMedix founded?
eMedix was founded in 1990. It employs 1 to 10 people.
Where is eMedix based?
eMedix is headquartered in Columbia, United States, in the North America region.
How does eMedix make money?
Two revenue lines are on record. Healthcare EDI & Claims Clearinghouse Services are the primary driver. The others are software-as-a-Service Platform Access.
Who are eMedix's main competitors?
Direct peers on record are Change Healthcare (Optum), QuadaX, Availity, Office Ally, Waystar and Experian Health. Emerging players are Claim.MD and Edifecs. Broad incumbents are Zelis (NaviNet) and Trizetto (Cognizant).
Does eMedix have an API?
No public API is recorded for eMedix.
What industry is eMedix in?
eMedix's product category is Healthcare Claims Clearinghouse & Revenue Cycle Software. Its primary akta.pro industry code is HLACABAK, Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment), with a secondary code of HLACAAAL, EHR Implementation, Optimization, Training & Managed Services. Its NAICS code is 5182 and its SIC code is 7370.