All solutions
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Solutions
Behavioral Health Solutions for Health Plans
Building a better future for behavioral healthcare with capabilities to support health plans, members and providers across the entire health continuum.
Behavioral Programs for the Justice-Involved
Optum helps direct people with behavioral health disorders in the criminal justice system to appropriate clinical and support services.
Solutions for People with I/DD
Ensure predictable costs while supporting positive outcomes.
Peer Support Services for Behavioral Health
Our peer services help people move from treatment to daily life and reduces re-admission.
Behavioral Health Solutions for Military and Veterans
Optum Serve is proud to offer evidence-based behavioral health solutions that support the needs of beneficiaries and their dependents.
Substance Use Disorders Solutions
We offer resources and support to help individuals achieve stabilization, build resiliency and sustain recovery.
Bariatric Resource Services
We help reduce medical expenses associated with bariatric surgery and provide support for your members, their family members and caregivers.
Optum Oncology Pathways
Our utilization management service for oncology treatments helps ensure members are receiving high-quality medical care at lower costs.
Optum Guide for health advocacy
Optum Guide™ helps your employees improve engagement with their health care benefits and connects them to the right care at the right time.
Focused Claims Review
Save on total claims dollars reviewed with this innovative approach targeting procedure, surgery and facility claims.
Physician Review for Workflow Management
Optimize your review and compliance processes with the next generation of workflow management.
Program Integrity Services
Our solution enhances and modernizes program integrity to combat fraud, waste and abuse by working to support the federal government.
Respiratory Disease Research
Supporting our clients in evidence generation for asthma, COPD and other respiratory disease products.
Voice-to-Claim® Research
Integrate patient and provider voices with research to enrich patient journey insights.
Cardiovascular Disease Research
Developing research to advance the treatment of CVD, including dysrhythmia, hypertension and heart failure.
HEOR Cardiovascular Publications
The cardiovascular team has expertise in evaluating clinical outcomes, treatment compliance, quality of life, and health care costs and utilization.
CNS and Behavioral Health Research
We have over 40 years of clinical and research experience in the central nervous system and behavioral health to produce data-based evidence.
Diabetes and Other Endocrine Diseases Research
We conduct research on treatment patterns, clinical outcomes, costs and utilization in diabetes and other endocrine diseases.
Oncology and Immunology Research
Offering expertise in solid tumors, hematologic malignancies and other inflammatory conditions.
Rare disease research
Our combined real-world data and extensive therapeutic expertise supports evidence generation strategies for rare disease.
Infectious Disease Research
Combining real-world data and extensive therapeutic expertise to showcase the value of ID therapies.
Streamline Data Collection in Clinical Trials
Improve regulatory-grade data collection with Optum True Source™ and ease clinical trial site burden.
Reduce the Burden on Clinical Trial Sites
The Optum Digital Research Network (DRN) is a multi-specialty network of participating provider sites with access to over 48M patients and 1,500 investigators.
Design and Pilot Engagement Programs
Work with the Cross Optum team and take advantage of our connections to all parts of the health system.
Optum Claims Data
Integrate and link deep patient data from multiple real-world sources to help clarify market dynamics and uncover insights.
Dynamic Assessment of Pregnancies and Infants
Drive informed decisions about maternal and infant health with our claims-based research database.
Clinicogenomics for Greater Data Insights
Better understand diseases and drug development opportunities.
Empower Commercial, Brand & Access Teams
CMM is a self-service, web-based reporting tool built on our proprietary data warehouse that gives a deeper understanding of product performance.
Clinical Assistant
An EHR-integrated solution that delivers advanced clinical decision support for guideline-directed, patient-specific medication recommendations.
Case Advisor
Artificial intelligence (AI) and evidence-based content are combined in this comprehensive utilization management (UM) workflow solution.
CareSelect® Risk Assessor
Automate breast cancer risk assessments with our EHR-integrated BRCA risk calculator.
CareSelect® Lab
Our Electronic Health Record (EHR)-integrated solution optimizes lab ordering, turning labs into key financial and clinical value centers.
CareSelect® Imaging
An EHR-integrated solution that helps providers increase order appropriateness, reduce authorization burden and comply with regulations.
CareSelect® Imaging Access
An integrated solution for smaller EHR vendors that enables the delivery of imaging decision support to their customers.
CareSelect® Imaging Open Access
Enable widespread access to the tools needed for compliance with federal and state regulations.
InterQual® Alliance Partners
Transforming utilization management with seamless integration of InterQual solutions.
Industry Content Navigator
Structured industry content to support consistent application of third-party content and policies and improve review workflow.
One Pass for Medicare
One Pass™ for Medicare is a proven fitness benefits partner and a total solution for mental, social and physical well-being.
Global Employee Assistance Program (EAP)
A modern employee assistance program that provides your employees with proactive support for everyday life.
Change Healthcare Imaging Fellow™
An EMR integration and data optimizer for radiologists to easily access clinical data at the point of care.
Change Healthcare Mammography Plus™
A single platform for both radiology PACS and mammography reading.
Change Healthcare Imaging Actionable Findings
A closed-loop communication solution for providers that notifies clinicians and patients of all acute and non-acute imaging findings.
Change Healthcare Image Repository™
A vendor-neutral archive solution for imaging departments that need an easy way to archive and manage medical imaging data.
Change Healthcare Enterprise Viewer™
A scalable, zero-footprint universal viewer platform for providers who want easy access to relevant imaging data.
Change Healthcare Cardiology Hemodynamics™
Learn about our integrated hemodynamic monitoring system for cardiology departments.
Change Healthcare Cardiology EP Solutions™
A comprehensive workflow, reporting and data management solution for cardiovascular departments that need to streamline workflows for electrophysiology implant and non-invasive procedures.
Change Healthcare Nuclear Medicine Advanced Visualization™
Learn how you can upgrade your nuclear imaging department with our web-enabled visualization software.
Cloud-Based Inventory Management
Healthcare inventory management tools that help hospitals get the actionable information they need to make informed decisions.
Enterprise Imaging Contract Staffing
A staffing solution that helps healthcare organizations quickly adjust medical enterprise imaging staffing levels to address short-term and long-term needs.
Provider Data Collaborative
Advance research, inform evidence-based practice and help improve patient outcomes by joining our virtual community.
Symmetry Suite
The Optum® Symmetry® suite produces standard units of analysis to help health plans manage costs, mitigate risk and measure quality.
Surgical Profitability Compass
Insights to improve surgical efficiency and maximize the revenue of your operating rooms.
Exchange Dx™ Solution
Our data management engine enables non-technical users to transform, create and share information in a self-service environment.
Explore Dx®
Our scalable business intelligence tool provides retrospective insight into pharmacy and healthcare organization business operations, sales, inventory and more, including healthcare and pharmacy data.
Engage Payers with Value-Based Contracts
Generate valuable evidence, leverage real-world data and analytics and track clinical outcomes over time.
Value-Based Contracting Experts
Meet Optum experts dedicated to value-based contracting who help stakeholders across the health system align to support patient access.
Market Clarity Data
Unlock insights using one of the industry’s largest and most trusted repositories of longitudinal clinical and claims data.
Optum EHR Data
Gain visibility across therapeutic areas and the continuum of care with electronic health record (EHR) data.
Plan with Confidence to Surveil Infectious Diseases
With the Optum® Infectious Disease Platform, you can target the right audience at the right time with the right message using precise data.
Change Healthcare Cardiology Charge Manager™
Our cardiovascular charge capture system leverages direct entry of procedural data at the point of care.
Change Healthcare Cardiology™ PACS
Our cardiovascular portfolio is a single-database solution that integrates with your EHR and VNA to transform care.
Change Healthcare Cardiology Cath™
Learn about our patient-centric cardiac imaging solution and information management system for hospital labs.
Change Healthcare Cardiology Echo™
Our echo reporting can improve clinical decision-making and reduce costs.
Change Healthcare Cardiology ECG Management™
Our ECG management solution is a web-based system that gives providers a comprehensive solution for a variety of procedures.
Change Healthcare Cardiology™ Analytics
Web-based reporting and business intelligence for providers to manage cardiology reporting, imaging analytics and administrative data.
Hospital Case Management Optimization
We offer real-time data and analytics, applied innovation, and expert guidance and investment in case management to optimize performance.
Information Technology (IT) Performance
Transform information technology, security, operations and economics to improve outcomes and enhance provider and patient experiences.
Patient Help Line
Optum experts address patients’ immediate symptom concerns and clinical questions, day or night, 365 days a year.
Practice Extend
Optum offers an impactful approach to facilitate value-based programs that drive improved outcomes and optimize cost of care.
Hospital Case Management Managed Service
Our service blends people, process and technology to deliver unparalleled value across key case management functions.
Practice Extend for Providers
An interdisciplinary team helps your practice advance patients' well-being, at no cost to you or your patients.
One Pass Select
One Pass Select™ is a subscription-based fitness membership and well-being network designed to support a healthier lifestyle for members.
Optum Hub
Our curated network of trusted vendor partners helps you create a simplified, more connected employee experience.
One Pass for Medicaid
Our program offers an extensive fitness network, online classes, personalized exercise content as well as grocery and household delivery.
Biometric Screenings and Vaccinations
Biometric screenings and vaccination offerings keep members engaged in their health.
OB Homecare Programs for Health Plans
Improve high-risk pregnancy outcomes and patient experience. Reduce the cost of care with skilled in-home nursing supported by technology.
OB Homecare Solutions for Providers
We provide holistic care to patients with specialized equipment and telemetry, unique medication delivery options and expert clinicians.
Neonatal support
Help improve outcomes for infants in the NICU and assist families in caregiving.
Fertility Solutions
Learn how Optum is simplifying the fertility journey through guidance and support.
Transplant Resource Services
We offer a high-quality nationwide provider network of transplant centers and industry-leading discounts.
Specialty Fusion
Experience a specialty drug management solution that does more by bringing medical and pharmacy benefits together at the point of care.
InterQual Coordinated Care
An integrated, cloud-based care coordination solution for complex care management.
Integrated Utilization Management
A comprehensive outsourced solution that combines expert operations with powerful AI-enabled technology to conduct timely, accurate nurse and physician reviews.
InterQual Optimization Solutions
High-quality clinical education, interrater reliability and customization solutions
InterQual[HJ1] Delivery
Streamline the medical review process with a variety of access options for using InterQual® Criteria.
InterQual Criteria
Our comprehensive solution offers clinical decision support designed to strengthen patient outcomes and reinforce appropriate utilization.
InterQual AutoReview
A medical review automation solution that increases utilization management (UM) efficiency and review accuracy.
Prescription Adherence and Clinical Management
Medical adherence tools to identify at-risk patients and intervene early.
Laboratory Affordability Products
Reduce your lab spend and improve patient outcomes with our comprehensive approach.
DME Navigator
Our integrated durable medical equipment (DME) solution helps health plans manage spend while improving the experience for members, DME suppliers and the ordering providers
Optimize Feasibility and Protocol Development
Build, explore and refine patient cohorts with our Prospector® Data Mining Studio.
State and Federal Reporting
Stay compliant and reduce costs with a proven CMS-certified solution.
Health Care Performance Analytics
See how Optum Health Care Performance Analytics helps state agencies improve program operations, policies and member outcomes.
Optum Program Integrity
Manage fraud, waste and abuse investigations in healthcare, from detection to collection, supporting fee-for-service and managed care.
Optum Rapid Insights as a Service
Create a comprehensive roadmap to better health equity with this valuable solution for states.
Policy, Research and Consulting
Get support to meet your members' changing needs with healthcare policy consulting expertise in the public, nonprofit, and private sectors.
Benefits Analytic Manager
Our integrated data and analytics solution for employers puts you in control of your data to inform strategy and manage benefits.
Community Care Services for Veterans
We ensure that our nation’s Veterans have access to the right care, at the right time and in the right setting.
Redefining the PBM experience
We are creating a simplified, more connected health care experience for you, your members, and the providers who care for them.
Driving appropriate utilization of medications
We are committed to helping members stay adherent to medications while addressing the industry challenges that prevent them from doing so.
Pharmacy Benefit Management for Health Plans
We help health plans customize networks, plan designs and formulary options, redefining quality with our expertise and claims processing technology.
Stop Loss Insurance
Protect your self-funded employer benefit plan from excessive expenses related to increased healthcare utilization.
Health Savings Accounts
Accelerate progress toward a healthier future with an HSA that helps employees take control of their care, payments and overall health.
Commuter Benefits
Support your employees with a pre-tax account that saves them money on qualified expenses for their individual commute to work.
Flexible Spending Accounts
Help your employees budget and save for qualified expenses during the benefit plan year through pre-tax contributions to FSAs.
COBRA Administration
Remove complexity, save time and increase compliance with our unique administration capabilities.
Healthy Food Benefits
Make fresh produce and healthier food a realistic option for all of your employees with instant rewards for purchasing nutritious products.
Lifestyle Spending Accounts
Attract and retain talent in a competitive market, connect your benefits to your culture and show you care for your employees.
Communications Complete
Our platform helps payers and administrators create, manage and distribute member communications.
Auto Insurance Claims
Maximize satisfaction and ROI by moving policyholders and service providers to electronic options.
Property and Casualty Claims
Boost customer satisfaction with payment experiences that lower costs and maximize ROI.
Medical Third-Party Administrators
Extend electronic options to all providers, driving cost savings and revenue sharing.
Payment Solutions for Healthcare Payers
Discover the value of a payment delivery solution designed for healthcare.
Workers’ Compensation Claims
Help payers deliver better workers’ compensation claim payment experiences.
Health Reimbursement Arrangements
Use a health reimbursement arrangement (HRA) to help offset employees’ healthcare costs while providing tax savings to the organization.
Credit Balance resolution services
We help health plans identify, research and resolve overpaid claims.
Coordination of Benefits
Identify and validate primary policy coverage with accurate eligibility data.
Claim Pricing solutions
Improve the accuracy and efficiency of your prospective payment system pricing.
Coding Advisor
Help providers reduce common billing errors with a proven education solution.
Data Mining
Identify claim errors and overpayments related to duplicates, coordination of benefits, billing issues and contract administration.
Emergency Department Claim Analyzer – Facility
Control rising emergency outpatient facility costs with automated, consistent and defensible E/M coding evaluation.
Comprehensive Denial Prevention
Help prevent claim denials by shifting your edits pre-adjudication or submission.
Subrogation for health plans
Identify, investigate, recover and prevent inaccurate payments linked to accident-related medical and disability expenses.
How to enroll in Optum Pay
As your partner, we invest in your practice and offer tools, support and funding to help you thrive.
Optum Pay
Accelerate progress toward a healthier future with a platform that helps expedite payments and streamlines access to historical claims data.
Working Capital Loans
Step into the future with 2 innovative loan solutions created exclusively for healthcare providers and systems, powered by Optum Bank.®
Optum Care Network–Connecticut
Help your clients become a patient with Optum Care Network–Connecticut in a few easy steps.
Enterprise Intelligence Suite
Unlock healthcare data and transform it into robust business intelligence, using AI-enabled feedback and suggested interventions.
Prevent claim denials with Provider Communication Gateway
This innovative solution offers a shift-left approach to help health systems proactively address claim denials rework and improve claims management.
News and Events
Stay up-to-date on the latest developments, initiatives and events with Optum Serve.
Strategy and Growth
We partner with organizations across healthcare to help them set a clear, deliberate and forward-looking strategy.
StepWise and Underwriting
Our underwriting software, capabilities and expertise help health plans simplify the design, deployment and distribution of products.
Analytics Consulting
We can improve your business performance through our industry-leading health care analytic advisors, the largest care databases and tools.
Group Risk Analytics
We help health plans leverage cutting-edge technology and advanced analytics to assess risk and optimize their portfolios.
Government Programs Advisory Services
We help health plans compete in a changing regulatory environment, stay agile and build for the future.
Community Care for Seniors
We bring an extra layer of ongoing clinical care to members who reside in an assisted living or skilled nursing facility.
Optum Integrated Eligibility Services
Our benefit determination system for Medicaid and human services programs simplifies eligibility for cost-effectiveness and efficiency.
Optum State-Based Exchanges
Optum State-Based Exchanges provide a robust and user-friendly SaaS approach for states looking to establish an ACA-compliant marketplace.
Optum Maintenance and Operations Services
Optum Maintenance and Operations offers a structured approach to eligibility and enrollment systems takeover and management.
Optum and WellMed Agent Resources in Florida
Our agents make it easy to connect your clients to high-quality care in Florida.
Optum Care Network–Arizona
Help your clients become a patient with Optum Care Network–Arizona in a few easy steps.
Practical Plans with Immediate Impact
Look to Optum Serve for expertise in healthcare, ranging from policy design to program research and beyond.
HouseCalls
In-home and virtual assessments support improved member health as well as performance on key Medicare Star Ratings measures.
PCPs and the Optum ISNP Care Model in SNFs
Close gaps in care and reduce fragmentation by participating in a cross-functional, team-based care experience.
Skilled Nursing Facility Programs
Break the high-cost cycle by increasing care and benefits to Institutional Special Needs Plan (ISNP) members.
naviHealth Post-acute Care Solutions
We help members transition from acute care to the next appropriate site of care, enhancing clinical outcomes and members’ experience.
Patient intake, engagement and retention
Our end-to-end digital patient intake and communications tools help you deliver care more efficiently with better outcomes.
Optum Market Advantage
Compete more effectively by finding growth opportunities in local and new markets with robust, actionable healthcare data analytics.
Consumer Acquisition Services
Leverage analytics to enhance patient acquisition and increase your marketing ROI.
Patient acquisition and online scheduling
Our leading-edge omnichannel approach helps you reach broader audiences with greater efficiency while improving the patient experience.
Optum Serve Mobile Medical Units
Meet community health needs in rural and urban areas with our fleet of medical-grade mobile units.
Assured Access: Rapid Resource Deployment in Emergencies
We help you bridge the gap between preparedness, response and recovery so you’re ready for emergencies and public health crises.
Federal Health Programs by Agency
Learn how we partner with the Departments of Defense, Health and Human Services, Veterans Affairs and other federal organizations.
Home Delivery Pharmacy for Payers
Our digital pharmacy is designed to meet your needs, simplify the medication delivery experience for patients, and grow alongside your business.
Risk Identification and Capture
Our holistic approach is designed to make it easy for clinicians to accurately document chronic conditions at the point of care.
In-Office Assessment Program
We partner with physicians to support positive patient outcomes.
Prospective Solutions
We support providers by standardizing processes on behalf of multiple payers to allow more time caring for patients.
Medicaid Risk Adjustment and Quality
Optum has the expertise, breadth and scale to help optimize and support your Medicaid risk and quality programs.
Risk View
Learn about our risk adjustment software platform that helps insurers better understand risk score trends and opportunities
Retrievals
Get industry-leading retrieval services with a national footprint and a continually expanding electronic retrieval program.
Submission Services
We provide end-to-end management of submissions, direct errors and remediation. Insights promote continual improvement to maximize accuracy.
Audit Services
Comprehensive solutions and support services to assist health plans in completing various audits established by CMS, HHS and the OIG.
Medical Record Retrieval
Maximize HEDIS collection and streamline medical review processes.
Dual Enrollment Advocate and Recert Complete
Our consumer-centric solution bundle helps health plans improve member satisfaction by helping members obtain and retain added benefits.
Community Connector
Assess SDOH (social determinant of health) needs and provide referrals to community-based organizations equipped to address those needs.
Smart Connect and Smart Appointment Scheduling
Services designed to engage members throughout their health care journey on behalf of payers.
Market Performance Partnership
Discover how we're accelerating health system performance and mission achievement.
Enterprise Pharmacy System™
A pharmacy management solution for all sizes and types of pharmacies that offers flexible deployment options including distributed, virtualized or cloud environments.
Converge Rx™
A workflow-integrated platform to increase revenue opportunities by performing, recording and billing non-dispensing patient care events.
One Assist
Our AI-enabled contact center solution helps states connect providers and members to the answers they need.
Preadjudication Suite
We offer a comprehensive approach for state Medicaid agencies to remove friction from the claims payment cycle and reduce payer/provider abrasion.
Provider Management Services for Medicaid Agencies
Provider Management Services improves the way Medicaid agencies manage provider relationships and administrative tasks.
Rx Cost Savings Advocate
A custom Rx claims solution that reduces cost for patients, payers, PBMs and pharmacies, by automating claims workflows.
Rx Edit
A comprehensive pharmacy claim solution designed to increase third-party reimbursements and improve in-store productivity.
Clinical Exchange ePrescribe
Our e-prescription software saves time and improves patient safety by enabling secure e-prescription generation and routing.
Clinical Exchange Orders and Results
Speed workflow with a connectivity solution that offers efficient, electronic order generation and results delivery.
Change Healthcare Workflow Intelligence™
A vendor-neutral, flexible medical imaging workflow rules engine for radiologists.
Change Healthcare Radiology Solutions™
An integrated, web-based picture archive and communication system (PACS) system for radiologists.
Change Healthcare Stratus Imaging Share
A cloud-based medical image sharing platform that allows providers to view and exchange medical images with payers, patients and EHRs.
Change Healthcare Stratus Imaging PACS
A reimagined, full-featured, cloud picture archive and communication system (PACS).
Change Healthcare Stratus Imaging Discover
A cloud-based learning and collaboration platform that allows health care professionals to create educational content and share it with their peers.
Change Healthcare Stratus Imaging Analytics
Empowering organizations to transform with real-time insights that enhance operational decision-making.
Change Healthcare Stratus Imaging Viewer
A cloud-based imaging solution that helps providers improve patient care by providing timely access to imaging.
Change Healthcare Stratus Imaging Archive
A fully managed, cloud-native medical imaging archive for providers who want to simplify image management, reduce IT costs and enable secure access from anywhere.
Assurance Reimbursement Management
Effectively automate your workflows to help prevent denials and facilitate fast reimbursement.
Business Office Performance Services
A customizable revenue cycle management solution for providers that want to access expert resources and technology.
A/R Recovery and Denial Management
Our A/R recovery and denial management solutions optimize your RCM workflow.
MedRx™ | Optum Business
HIM Performance Outsourcing
Discover how Optum can help you create more stable revenue and workflow with health information management outsourcing.
Revenue Integrity
Leverage innovative technology and expert staff to optimize the middle revenue cycle and drive maximum reimbursement compliance.
Clinical Language Intelligence (CLI)
Learn how Optum AI products use natural language processing (NLP) to make healthcare work smarter.
Pulse Revenue Cycle Benchmarking™
Our analytics-driven competitive analysis solution gives increased visibility into claims cycle and benchmark performance.
Acuity Revenue Cycle Analytics™
Our analytics-driven revenue cycle management software to help you make decisions impacting outcomes, productivity and patient experiences.
Enterprise CAC and CDI 3D
Review medical records and deliver comprehensive, accurate code suggestions with technology powered by Optum Clinical Language Intelligence.
Professional Computer Assisted Coding (CAC)
Our advanced coding solution automates medical coding and charge capture processes.
Codebooks and training
Comprehensive and proven coding tools for professionals in physician practices, hospitals, post-acute services and payer organizations.
LYNX Outpatient Charge Capture
Our extensive charge capture solution helps protect revenue and supports compliant and consistent charging across outpatient operations.
Absolute AR
A suite of pharmacy revenue cycle management solutions that brings clarity and transparency to third-party submission and reconciliation.
Revenue Performance Advisor
An end-to-end revenue cycle management software solution to simplify workflows, reduce denials, optimize revenue and improve engagement.
SmartPay Plus™
Our patient payments solution helps providers accelerate collections, improve the patient financial experience and simplify workflows.
Coverage Insight™
Our analytics-driven insurance verification software for providers helps you identify undisclosed coverage for patients.
Patient Financial Clearance
Our pre-service clearance insurance verification solution accelerates reimbursement, reduces denials and optimizes workflows.
Eligibility and Enrollment Services
A customizable solution for providers to help find coverage for self-pay patients.
Patient Access Contact Center Services
Strategic patient access and call center services for hospitals, health systems and large physician groups.
Connected Authorization Services
Improve medical authorization management by leveraging expert staffing, intelligent automation and broad connectivity.
Dental Converge
Dental Converge claims software helps dental practices create speed and accuracy with claims submission, tracking and payment.
Dental Benefits Advisor
Our advanced eligibility solution helps dental providers identify accurate patient and insurance responsibility at point of service.
Payer Connectivity Services
Our claims system for payers and TPAs consolidates transaction streams at a single point to manage administration, routing and adjudication.
Hosted Payer Services
Integrated technology helps lower costs of maintaining high-availability systems needed to support dental and medical providers and members.
Portals
Optum offers multiple portal options to fit the specific needs of your organization.
EDI Network
Enable faster, more accurate claim processes with digital transactions, customizable edits and cloud-based solutions linking care delivery.
Rx CardFinder™ Services
A pharmacy eligibility service that checks patient coverage with the nation’s largest Pharmacy Benefit Managers (PBMs) and returns real-time responses.
Optimal Pharmacy Network Strategy
Our full-spectrum pharmacy services are designed to provide affordable access to prescription medications and therapies.
Rx Connect™
Our claims switch adjudication network allows pharmacies to send claims in real time to any U.S. third-party processor.
Rx Assist
Our dynamic copay assistance and messaging platform helps deliver real-time prescription savings and educational messaging to patients.
Pharmacy Network for Hospice Care
Provide patient access to retail pharmacies, home delivery, infusion care and discounted medications that aren’t otherwise covered.
Hospice Pharmacy Clinical Programs
Dedicated clinical consulting team trained in hospice care, provides strong support for your staff to help lower your costs.
Hospice Pharmacy Analytics Tools
Track real-time drug utilization, monitor trends, identify opportunities and compare performance against benchmarks on key metrics.
Hospice Technology Solutions
Flexible technology solutions that help you manage patients’ eligibility, medication information and medication plan of care.
HospiBooks
Expert advice helps you enhance patient care. HospiBooks publications offer clear, detailed guidance on common elements of hospice care.
Hospice Pharmacy Educational Resources
Staff access to clinical information and a library of patient care tools and guides, as well as continuing education resources.
Weight Engage
Get the most from these pricey new obesity drugs by choosing the right coverage strategy and helping your members build lifelong habits.
Using data to improve health equity
Everyone deserves access to affordable healthcare. Learn how we’re using data and analytics to identify disparities and take steps toward health equity for pharmacy members.
Regulatory Updates with Optum Rx
Stay up-to-date on what’s happening in pharmacy legislation that has the potential to adversely impact pharmacy benefits offered by both fully insured and self-insured clients.
Prior authorization for prescribers
Help manage costs, control misuse and protect patient safety to ensure the best possible therapeutic outcomes.
Immunology Center of Excellence
Gain access to therapy-specific tools and resources to get your patients with immunology conditions started on therapy quickly and efficiently.
Specialty and Infusion Drug List
Use our search tool to find medications that Optum Specialty Pharmacy and Optum Infusion Pharmacy can provide or facilitate access to.
Specialty Pharmacy Provider Portal
Our online portal helps you manage administrative tasks, so you can spend more time with your patients.
Neurology Center of Excellence
When you work with the Optum Neurology Center of Excellence, we provide helpful resources so you can spend more time with your patients.
Oncology Center of Excellence
We offer the clinical expertise and in-depth, customized care that you need so your practice can focus on one thing – the patient.
Pharmacy Appeals
When patients are denied access to medications and treatments they need, our Pharmacy Appeals team is here to help.
Pharmacy Support for Hospitals and Health Systems
Get trusted support sourcing specialty and infusion therapies or discharging patients for treatment at home.
Specialty Pharmacy for Pharma Manufacturers
Our expert specialty clinicians develop new ways to support advanced therapies, evolve protocols and bring future medications to market.
Specialty Pharmacy Community Residency
This 12-month post-graduate program offers a unique community practice environment to develop expertise in specialty pharmacy.
Pharmacy Care Support for Payers
Patient care is our priority. Our insights drive informed decisions and control costs – without compromising quality of care.
Electronic Prescribing (eRx) to Optum Home Delivery
Enable accurate and efficient electronic prescribing to send prescriptions directly to the pharmacy.
PreCheck MyScript: Real-Time Benefits Check Tool data
Get patient-specific prescription costs, lower-cost options and coverage details right at the point of care through your EHR platform.
RCM Services for Anesthesia Practices
Industry-leading RCM services help anesthesiologists increase speed to payment, contain costs at a faster rate, and support financial performance.
RCM Services for Emergency Medicine Practices
Industry-leading services help emergency medicine practices improve performance and reduce costs while focusing on accuracy and speed of outcomes.
Revenue Cycle Management for EMS Agencies
Industry-leading RCM and billing services for EMS agencies and ambulance organizations support cash flow and increase speed to payment.
RCM for Pathology Practices
Revenue cycle management services help pathologists reduce ineffective touches, increase speed to payment and improve cash flow.
RCM for Telehealth and Virtual Care
RCM services help telehealth organizations speed up payments, improve accuracy and support growth.
RCM for Multispecialty Practices
Optimize your revenue cycle with industry-leading services from a partner at the center of the healthcare system.
RCM for Radiology Practices
We bring decades of revenue cycle management (RCM) and medical billing experience to help radiology practices improve reimbursement and cash flow.
RCM Services for Laboratories
Industry-leading RCM services help labs reduce ineffective touches, increase speed to payment, and quickly improve cash flow.
Optum Care Network–Utah
Help your clients become a patient with Optum Care Network–Utah in a few easy steps.
Risk Management and Analytics Consulting
Get insights into risk and quality management with the right mix of talent, operating models, platforms and analytics.
Stratus Flex for Radiology
A flexible cloud solution for hospitals and imaging centers to improve security, savings and enhance scalability.
Cardiopulmonary Center of Excellence
Innovative programs and in-depth support help you deliver precise care for patients with asthma, cystic fibrosis and more.
Gastroenterology Center of Excellence
Clinical expertise from pharmacists and a devoted provider support team, all with years of experience working with gastroenterology conditions.
Health benefits
We empower employees and members to take control of their health and well-being.
Operations and technology
Helping organizations evolve through market-leading technology, modernized platforms and unrivaled expertise.
Data and analytics
Our platforms help healthcare organizations turn real-world data, business intelligence and data analysis into invaluable insights.
Financial solutions
Explore our tailored solutions for the healthcare industry and learn how we can help you achieve financial health and operational excellence.
Brokers and Consultants
Gain a competitive edge by connecting your clients with innovative, best-in-class and cost-effective Optum solutions.
Consulting services
We help healthcare leaders and organizations create change and drive growth.
Partner for success with Optum
Partnering with us helps you to grow and expand your business, develop innovative solutions and make healthcare better for everyone.
Healthcare access
We’re improving the patient and member journey by providing better and easier access to healthcare.
Pharmacy services
Drive better engagement, medication adherence and outcomes for patients.
Pharmacy benefit management
Manage pharmacy spend across a health system and explore hospice solutions.
Behavioral health and emotional wellbeing solutions
We guide adults, youth and caregivers to the right support and care for their unique needs across a full range of mental health tools and solutions.
Behavioral Health Solutions for State Governments
Our targeted interventions and complex care management help to enhance patient experience, lower costs and improve outcomes.
Behavioral Health Solutions for Employers
Provide employees with convenient access to effective behavioral health resources.
Complex care management
Discover simple solutions for complex conditions to reduce the cost of care, manage organizational risk and improve outcomes.
Oncology Solutions
Our solutions address complex challenges and help manage cancer costs while improving outcomes and quality of care.
Optum Serve technology and consulting solutions
We help clients optimize their strategies and services by enhancing data and technology systems and leveraging policy research and design.
Strengthen your value story with HEOR
Tap into our expertise in health economics and outcomes research.
Generate Evidence with Real-World Data
Derive evidence from the unmatched depth and scale of our data assets.
Partner with Our Epidemiology Consultants
Advance public health and safety with our trusted experts and data.
Clinical Decision Support
We bring together the clinical and financial to drive appropriate, high-value care.
CareSelect
Point-of-order clinical decision support solutions to increase appropriate ordering and drive high-value care across the enterprise.
InterQual
Our evidence-based clinical decision support solution for payers, providers and government agencies.
Change Healthcare Radiology Solutions
Improve productivity with an AI-enabled enterprise radiology portfolio to streamline workflow.
Performance
Drive growth, financial performance and clinical excellence with actionable data and analytics through technology and managed services.
Pharmacy Business Intelligence Solutions
Data management and analysis tools that let pharmacies analyze store performance in real time.
Gain a Truer Picture of Disease Prevalence
Optum Enlighten is a groundbreaking pharma intelligence platform that identifies disease prevalence in populations at a hyper-local level.
Change Healthcare Cardiology™ Solutions
Coordinate care and reduce imaging complexity with our integrated cardiology solutions.
Enterprise Imaging
Accelerate your digital transformation and improve patient outcomes in enterprise imaging.
Prevention and well-being
Connect employees and members with relevant, engaging health and wellness programs.
Women's Health Solutions
Our flexible continuum of care helps to improve outcomes and reduce costs for women and families.
Specialty Management
Simplify specialty care with medical and pharmacy solutions that deliver enhanced analytics to inform strategy and lower costs.
Ancillary benefits management
Reduce the burden of managing ancillary benefits programs separately across the care continuum. Our solutions leverage an affordability framework to close gaps for better care with lower costs.
Clinical Operations
Bridge the clinical and financial aspects of health care to provide more effective and cost-efficient patient care.
Enhance Clinical Trial Design and Performance
Modernize your approach to protocol design and patient finding.
Life Sciences Solutions
We connect data and ideas for the life sciences industry to the rest of the healthcare ecosystem to catalyze innovation and impact.
Data & Analytics Solutions for State Governments
Improve decision-making and outcomes with a suite of advanced enterprise analytics products.
Controlling specialty drug costs
The cost and complexity of specialty drugs requires a solution that provides care without compromise. The outcome is a better experience and lower costs.
Health benefit accounts
Our solutions help employers simplify the management of health-related finances and create a healthier workforce.
Payment delivery solutions
Transform the claim payment process for payers and payees with our payment solution.
Claim Review
Prevent improper payments, reduce medical spend and minimize provider abrasion with our comprehensive suite of pre- and post-pay solutions.
Payment integrity solutions for health plans
Improve payment accuracy and maximize medical expense savings across the claim lifecycle.
Claims Edit System
Achieve clean claims and maximize medical spend savings with our flexible, real-time claim editing software.
Payments and lending
Optum Financial® connects you with healthcare payment solutions and to loans powered by Optum Bank.
Technology Consulting
Our solutions improve efficiency, lower costs and deliver value across the healthcare ecosystem.
Healthcare consulting services
Our services turn your challenges into opportunities as we help you create more equitable and efficient systems of quality care.
Home & Community
Our personalized care solutions are designed to meet each individual’s physical, mental and social needs across diverse care settings.
Healthcare Access for State HHS Agencies
Simplify access to care for all your health and human services programs, improving benefits enrollment and user experience.
Healthier care for your clients
Find resources to help deliver personalized and coordinated care for patients.
Optum Serve consulting
We provide analytics that help decision-makers develop and strengthen health care programs and make informed policy choices.
Provider Growth and Analytics
Get healthcare provider analytics solutions that help you improve practice performance and achieve your growth goals.
Patient Access and Engagement
Improve your digital patient access and engagement journey while reducing costs and increasing patient satisfaction.
Public Health, Preparedness, Response and Recovery Services
Optum Serve offers strategies to prepare for, respond to and recover from public health emergencies, crises and disasters in your community.
Optum Home Delivery Pharmacy
We deliver the efficiency of a digital pharmacy with a level of expertise, reliability and accuracy that consumers expect.
Retrospective Solutions
Our diverse and deep experience paired with the largest MA database in the industry powers analytics to improve accuracy and completeness.
Risk adjustment, quality and engagement
Reduce worries with sustained financial risk management.
Quality Solutions
Improve quality with a comprehensive, innovative approach to manage HEDIS® performance.
Member Engagement Solutions
We help health plans precisely target the right members and efficiently deliver programs based on member needs.
Pharmacy Technology Solutions
We support the entire pharmacy claims life cycle, with unparalleled data and insights to optimize pharmacy operations.
Pharmacy Management Software Solutions
A solution suite that helps promote patient clinical interventions such as medication adherence, to build engagement and loyalty.
Program Operations
Transform your state’s operations with modern technology complemented by services.
Network connectivity
Enhance connectivity and streamline EDI transactions for health care providers, health plans and pharmacies through our nationwide network.
Clinical Exchange Solutions
Support interoperability connecting hospitals, labs and radiology and device organizations with providers and their EHR systems.
Stratus Imaging
A cloud-native enterprise imaging platform for providers who want to improve clinical and operational efficiencies.
Medical claims and reimbursement management
Improve claims accuracy and prevent claim errors to minimize denials and boost reimbursement.
Revenue Cycle Analytics
Transform disparate data into actionable insights to enhance your revenue cycle performance.
Medical Coding and Documentation Services
Augment resources and expertise for greater accuracy, powered by industry-leading technology and clinical intelligence.
Pharmacy Revenue Cycle and Billing Solutions
A suite of medical claims billing and revenue cycle management solutions that help pharmacies boost revenue.
Patient payments
Get patient financial engagement e-cashiering solutions to increase revenue performance and patient satisfaction.
Ambulatory Revenue Cycle Technology
Get end-to-end, automated revenue performance solutions to optimize cash flow, streamline workflows and improve patient experience.
Patient Access
Our patient access services help you improve engagement, loyalty and revenue while driving patient acquisition.
Dental Revenue Cycle Management
Gain time and cost efficiencies while accelerating verifications and payments with our suite of solutions for dental providers and payers.
Medical Network Solutions
Leverage our vast nationwide connectivity to streamline eligibility verification and claims processing to help drive accuracy.
Pharmacy Network Solutions
A claims-management tools that help pharmacies expedite claims editing, submission and adjudication.
Hospice pharmacy solutions
Manage pharmacy spend across a health system and explore hospice solutions.
Improving medication affordability
Providing you with solutions that make it easier to lower drug spend.
Caring for pharmacy members
We promise to deliver simple ways for your employees to get the medication they depend on – while advancing health equity for everyone.
Driving pharmacy innovations
You need simple, intelligent and adaptive solutions for your pharmacy benefit plan – fueled by the power of Optum.
Leading the industry in transparency
We deliver accessible and clear pharmacy benefit information, transparent drug pricing, and a simplified experience for everyone we serve.
Specialty Pharmacy for Providers
We make patient referrals, enrollment processes and online prescriptions easy for providers.
Optum Specialty Pharmacy
Personalized support for specialty medications. We combine expertise with empathy to unlock new value for patients, pharma, providers, and payers.
Optum Infusion Pharmacy
We offer consistent, convenient and compassionate infusion services.
Home Delivery Pharmacy for Providers
We increase patient medication adherence and satisfaction with home delivery.
Revenue cycle management
Solutions to help you strengthen margins, improve efficiency and elevate the patient experience.
Ambulatory Revenue Cycle Management Services
RCM and billing services help physicians improve cash flow, increase speed to payment, contain costs at a faster rate, and support growth at scale.
Management Consulting
We help health care organizations examine and enhance their strategies to meet and exceed evolving member needs and expectations.