EXHIBIT 10.14


                           LETTER WAIVER


                                                     Dated as of January 8, 1999



Bank of America Illinois
Nine West 57th Street, 43rd Floor
New York, New York 10019


Ladies and Gentlemen:


                  We refer to the  Credit  Agreement  dated as of  December  18,
1995,  and  amendments  thereto  dated as of January  10,  1997,  April 4, 1997,
October 30, 1997, December 29, 1997, October 7, 1998 and December 15, 1998 (such
Credit Agreement,  as so amended,  the "CREDIT AGREEMENT") among the undersigned
and you.  Capitalized  terms not  otherwise  defined in this Letter Waiver shall
have the same meanings as specified therefor in the Credit Agreement.

                  We intend to issue up to 4,791,667 shares of our common stock,
par value $.01 per share (the  "SHARES"),  in an initial  public  offering  (the
"IPO").  Upon consummation of the IPO, (i) the Guarantors will own approximately
56% of the  voting  stock  of  the  Company  (assuming  that  the  underwriters'
overallotment option has not been exercised) and (ii) we expect to receive up to
$56,231,254 (the  "PROCEEDS"),  after deduction for underwriting  fees and other
costs and expenses incurred in connection therewith.

                  We hereby  request that you waive,  solely with respect to the
IPO and the transactions contemplated thereby, the requirements of Sections 7.11
and 8.01(k) of the Credit Agreement in order to permit us to consummate the IPO,
and to enable us to use the Proceeds to (x) prepay all outstanding  Indebtedness
under  and in  respect  of the 10%  Subordinated  Note  issued  to WCAS  Capital
Partners II, L.P. pursuant to the Note and Share Purchase  Agreement dated as of
February 14, 1997 between  WCAS Capital  Partners II, L.P. and the Company,  and
(y) only to the  extent of any  Proceeds  received  from  Shares  sold under the
underwriters'  overallotment  option, to pay accrued and unpaid dividends on the
Company's preferred stock, par value $.01 per share; provided, however, that (i)
the  Proceeds  remaining,  if any,  after such  prepayment  and such  payment of
dividends,  if any, has been made shall be applied to prepay amounts outstanding
under and in respect of the Credit  Agreement  in  accordance  with the terms of
Section 2.06 thereof and (ii) after the IPO, the  Guarantors  continue to own at
least 35% of the voting stock of the Company.  A breach of the conditions in the
proviso  to the  immediately  preceding  sentence  will  constitute  an Event of
Default under the Credit  Agreement.  Unless the IPO shall have been consummated
on or prior to March 31, 1999 (the  "WAIVER  TERMINATION  DATE"),  on the Waiver
Termination  Date,  without any further action by the Bank, all of the terms and
provisions set forth in the Loan  Documents with respect to Defaults  thereunder
that are waived  hereunder  and not cured prior to the Waiver  Termination  Date
shall  have the same  force and  effect as if this  Letter  Waiver  had not been
entered  into by the parties  hereto,  and the Bank shall have all of the rights
and remedies  afforded to it under the Loan  Documents  with respect to any such
Defaults as though no waiver had been granted by them hereunder.

                  This Letter Waiver shall become effective as of the date first
above  written  when,  and only when the Bank shall have  executed  this  Letter
Waiver and shall have received  counterparts  of this Letter Waiver  executed by
us, and the consents  attached hereto  executed by each of the  Guarantors.  The
effectiveness  of this Letter  Waiver is  conditioned  upon the  accuracy of the
factual  matters  described  herein.  This  Letter  Waiver  is  subject  to  the
provisions of Section 9.01 of the Credit Agreement.

                  The  Credit  Agreement,  the Notes and each of the other  Loan
Documents,  except to the extent of the waiver specifically  provided above, are
and shall continue to be in full force and effect and are hereby in all respects
ratified and confirmed. The execution, delivery and effectiveness of this Letter
Waiver shall not, except as expressly  provided  herein,  operate as a waiver of
any  right,  power or remedy of the Bank  under any of the Loan  Documents,  nor
constitute a waiver of any provision of any of the Loan Documents.

                  If you  agree  to the  terms  and  provisions  of this  Letter
Waiver,  please  evidence such agreement by executing and returning at least two
counterparts of this Letter Waiver to Shearman & Sterling, 599 Lexington Avenue,
New York, New York 10022, Attention: Douglas Buffone.

                  This   Letter   Waiver  may  be  executed  in  any  number  of
counterparts and by different parties hereto in separate  counterparts,  each of
which when so executed  shall be deemed to be an original and all of which taken
together shall  constitute one and the same  agreement.  Delivery of an executed
counterpart  of a signature  page to this Letter Waiver by  telecopier  shall be
effective as delivery of a manually executed counterpart of this Letter Waiver.






                  This Letter  Waiver  shall be governed  by, and  construed  in
accordance with, the laws of the State of New York.


                                                       Very truly yours,

                                                       MEDE AMERICA CORPORATION


                                                       By 
                                                          ----------------------
                                                          Name:
                                                          Title:


Agreed as of the date first above written:

BANK OF AMERICA ILLINOIS


By
   ----------------------
   Name:
   Title:







                                     CONSENT



                                      Dated as of January 8, 1999

                  The undersigned,  Welsh,  Carson,  Anderson & Stowe V, L.P., a
Delaware limited  partnership,  as a Guarantor under the Guaranty dated December
18,  1995 (the  "GUARANTY")  in favor of the Bank party to the Credit  Agreement
referred  to in the  foregoing  Letter  Waiver,  hereby  consents to such Letter
Waiver and hereby confirms and agrees that  notwithstanding the effectiveness of
such Letter Waiver, the Guaranty is, and shall continue to be, in full force and
effect and is hereby ratified and confirmed in all respects.



                                       WELSH, CARSON, ANDERSON & STOWE V, L.P.


                                       By   WCAS V Partners, its General Partner


                                       By
                                          --------------------------------------
                                          Name:
                                          Title: General Partner





                                     CONSENT



                                       Dated as of January 8, 1999


                  The undersigned,  Welsh, Carson,  Anderson & Stowe VI, L.P., a
Delaware limited  partnership,  as a Guarantor under the Guaranty dated December
18,  1995 (the  "GUARANTY")  in favor of the Bank party to the Credit  Agreement
referred  to in the  foregoing  Letter  Waiver,  hereby  consents to such Letter
Waiver and hereby confirms and agrees that  notwithstanding the effectiveness of
such Letter Waiver, the Guaranty is, and shall continue to be, in full force and
effect and is hereby ratified and confirmed in all respects.

                                      WELSH, CARSON, ANDERSON & STOWE VI, L.P.


                                      By   WCAS VI Partners, its General Partner


                                      By
                                         ---------------------------------------
                                         Name:
                                         Title: General Partner






                                     CONSENT



                                       Dated as of January 8, 1999


                  The undersigned,  William Blair Leveraged Capital Fund Limited
Partnership,  a Delaware limited partnership,  as a Guarantor under the Guaranty
dated  December  18,  1995 (the  "GUARANTY")  in favor of the Bank  party to the
Credit Agreement referred to in the foregoing Letter Waiver,  hereby consents to
such  Letter  Waiver and hereby  confirms  and agrees that  notwithstanding  the
effectiveness of such Letter Waiver,  the Guaranty is, and shall continue to be,
in full force and effect and is hereby ratified and confirmed in all respects.

                          WILLIAM BLAIR LEVERAGED CAPITAL FUND
                          LIMITED PARTNERSHIP


                          By   William Blair Leveraged Capital Management, L.P.,
                                 its General Partner


                          By  William Blair & Company, its General Partner


                          By
                            ----------------------------------------------------
                            Name:
                            Title:







                                     CONSENT

                                       Dated as of January 8, 1999

                  The  undersigned,  William Blair  Capital  Partners V, L.P., a
Delaware limited  partnership,  as a Guarantor under the Guaranty dated December
18,  1995 (the  "GUARANTY")  in favor of the Bank party to the Credit  Agreement
referred  to in the  foregoing  Letter  Waiver,  hereby  consents to such Letter
Waiver and hereby confirms and agrees that  notwithstanding the effectiveness of
such Letter Waiver, the Guaranty is, and shall continue to be, in full force and
effect and is hereby ratified and confirmed in all respects.

                                       WILLIAM BLAIR CAPITAL PARTNERS V, L.P.

                                       By   William Blair Capital Partners, LLC,
                                                its General Partner

                                       By
                                         ---------------------------------------
                                         Name:
                                         Title: