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Operations and technology

Network connectivity

Enhance connectivity and streamline EDI transactions for health care providers, health plans and pharmacies through our nationwide network.

Transform system performance with network connectivity

Interoperability in healthcare is essential for efficient care delivery and performance. A health system’s network connectivity must be capable of handling fast, accurate data exchanges and secure private information.

It needs to work seamlessly across various systems and standards while managing a high volume of transactions. 

Simplifying these processes can remove complexities and streamline information flow. Reimbursement is accelerated while costs are lowered. When selecting a network partner, health systems should prioritize security, scalability and reliability.

Optum network connectivity

Expand your connectivity and streamline EDI transactions, including eligibility verification and claims processing, through our vast nationwide network. 

We serve medical and dental health care providers, health plans and pharmacies. Our clearinghouse provides advanced interoperability, enhanced security and scalability to help drive accuracy, improve efficiency and reduce costs.

Automation helps streamline processes such as eligibility and benefit verification, claim status checks and proactive claim validation. New product features are rapidly implemented while our expanded network capacity offers scalability for any level of volume. 

Our infrastructure, servers and data centers are built to the highest standards, using the latest technology in partnership with industry-leading security vendors. Firewalls configured for maximum strength and multi-factor authentication for all systems meet best-in-class security measures.

Delivering on interoperability

  • Speed: With investments in modernization, Optum offers instantaneous eligibility checks (within milliseconds) and rapid response times while optimizing for fewer timeouts and error rates.
  • Quality: We are uniquely positioned to ensure quality of data through robust operational processes and real-time edits. Our ancillary services allow us to identify critical information at the most granular level to meet the needs of our customers. 
  • Reliability: Continuous improvements and investments in modern infrastructure result in consistent and performant system uptimes and availability.

Medical, pharmacy and clinical networks

Medical Network Solutions

Leverage our vast nationwide connectivity to streamline eligibility verification and claims processing to help drive accuracy.

EDI Network

Enable faster, more accurate claim processes with digital transactions, customizable edits and cloud-based solutions linking care delivery.

Dental Revenue Cycle Management

Gain time and cost efficiencies while accelerating verifications and payments with our suite of solutions for dental providers and payers.

Pharmacy Network Solutions

A claims-management tools that help pharmacies expedite claims editing, submission and adjudication.

Clinical Exchange Solutions

Support interoperability connecting hospitals, labs and radiology and device organizations with providers and their EHR systems.

Hosted Payer Services

Integrated technology helps lower costs of maintaining high-availability systems needed to support dental and medical providers and members.

Payer Connectivity Services

Our claims system for payers and TPAs consolidates transaction streams at a single point to manage administration, routing and adjudication.

Clinical Exchange Orders and Results

Speed workflow with a connectivity solution that offers efficient, electronic order generation and results delivery.

Clinical Exchange ePrescribe

Our e-prescription software saves time and improves patient safety by enabling secure e-prescription generation and routing.

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Learn how our network connectivity can help your business