Q&A: How Optum Financial is modernizing healthcare payment delivery

Efficient payment delivery is critical to the healthcare ecosystem, but many providers still struggle with fragmented payment processes, manual reconciliation and outdated systems. Optum Financial is taking a proactive approach to solving these issues, leveraging technology and its extensive network to transform how payments flow between payers and providers. By driving digital adoption and standardizing processes, Optum Financial aims to make payment delivery faster, simpler and more impactful for healthcare organizations.

In this Q&A, Brian Andrews, senior vice president of payer-to-provider payments at Optum Financial, shares insights into the company’s current payment delivery solutions, its vision for the future and the ways it is tackling industry challenges. Andrews highlights how the extensive Optum Financial network is creating efficiencies that improve the financial operations of healthcare providers.

Can you provide an overview of the current payment delivery solutions offered by Optum Financial?

Optum Financial processes more than $500 billion in healthcare payments annually, connecting 2.5 million providers at the National Provider Identifier level and about 400,000 providers at the Tax Identification Number level. The solution accelerates digital adoption by moving from paper checks and manual remittance processes toward digital solutions like Automated Clearing House (ACH) transactions and Electronic Remittance Advice (ERA) files. This shift not only reduces costs for payers but also enables providers to receive payments quickly and reconcile them more efficiently. Providers benefit from flexible payment options, including enhanced ACH, virtual credit cards and even paper checks, if preferred.

We support this transition with standardized remittance files that help automate reconciliation and posting, minimizing manual work and enhancing financial operations.

What is the process to ensure these solutions are integrated into existing payer infrastructure?

Our integration process enables payers to deliver digital payments directly to a pre-validated set of providers. Providers benefit from the flexibility to manage payment preferences across multiple payers within our network, eliminating the need for payer-by-payer configuration.

We reduce variation in remittance formats across payers, helping providers integrate easily with their practice management systems or EMRs. By standardizing remittance files, we support automated reconciliation that helps streamline workflows and accelerate payment cycles, resulting in a consistent, efficient experience for both payers and providers.

How is Optum Financial incorporating the consumer payment experience into its broader healthcare payment solutions, and why is this differentiation important?

Optum Financial is actively integrating consumer payment experiences into its healthcare payment solutions. This approach creates a more cohesive and streamlined ecosystem. By focusing on the needs of patients, we are addressing a critical gap in the healthcare payment process. Specifically, we are bridging the payer-to-provider and consumer-to-business payment flows.

One way we are differentiating ourselves is by leveraging real-time application programming interfaces (APIs). These APIs allow patients to access upfront cost information and make payments more efficiently. This transparency empowers patients to make informed financial decisions. It also helps providers improve collections and reduce administrative burdens.

Our partnerships with Rectangle Health and PatientPay play a key role in delivering these consumer payment innovations. These collaborations enhance the patient payment experience and align with our vision of becoming a fintech leader in healthcare, rather than simply a payment processor.

What is the Optum Financial vision for the future of payment delivery and reconciliation in the healthcare industry?

We envision a future where healthcare payments evolve into a seamless, fintech-driven ecosystem that empowers providers, payers and patients alike. Our goal is to unify fragmented payment networks into one system that integrates payer, provider and consumer-to-business (C2B) payment flows.

For providers, we aim to go beyond traditional payment delivery by offering innovative financial tools that support practice growth and operational efficiency. Through the Optum Bank digital wallet platform, providers gain access to healthcare-specific benefits, such as discounts on business purchases, working capital loans and equipment financing. These tools help providers manage their finances more effectively and enable greater focus on delivering care.

For payers and patients, we are addressing the growing need for transparency and modern digital payment solutions. By utilizing real-time APIs and embracing a "send and spend" model, we ensure funds are delivered quickly and securely, reducing friction in both payer and patient experiences. This model empowers patients to better manage their healthcare costs and improves efficiency in payment flows.

How is Optum Financial positioned to tackle challenges in healthcare payments and to lead innovation in this space?

By leveraging advanced technology and deep industry partnerships, Optum Financial addresses payment challenges across the healthcare system.

For example, our Straight Through Processing (STP) technology automates claims posting and integrates virtual card payments directly into providers’ revenue systems, eliminating manual reconciliation tasks. This reduces processing time, improves cash flow and allows providers to focus more on patient care. The positive market feedback we've received underscores the significant impact STP is having in streamlining operations and improving financial management for providers.

For patients, we prioritize improving the payment experience by offering tools that provide real-time cost transparency, such as UnitedHealthcare’s efforts to deliver upfront cost information. These tools empower patients to make informed financial decisions, while also helping providers improve collections and reduce administrative burdens.