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Hosted Payer Services

Reduce payer administrative costs and remove technical barriers by providing real-time eligibility and claim status services on behalf of payer customers.

Modernize medical and dental networks

Industry-leading security, stability and responsiveness

Hosted Payer Services (HPS) is built on the latest Amazon Web Services (AWS) technology and is integrated with the vast Optum clearinghouse.

Market-leading availability and response times can help lower support and development costs while increasing medical and dental provider satisfaction.

Clients using our Hosted Payer Services have experienced sub-second real time responses and 99.9% availability.

HPS removes technical barriers and the costs of providing real-time EDI responses

Real-time processing

Hosted eligibility and claims status processing

  • Helps reduce administration costs for payers and third-party administrators
  • Can remove technical barriers
  • Increased provider satisfaction

Cost clarity

Unparalleled pricing benefits

  • Per-member, per-month pricing
  • No transaction limits
  • Grows as you grow
  • Predictable/non-seasonal costs

Enhanced support

Increased value for payers and third-party administrators

  • Infrastructure cost removal
  • Help lower support and development costs
  • Market-leading availability
  • Market-leading response times

Key benefits

Hosted eligibility and claim status

HPS can help reduce administrative costs by receiving and responding to standard medical transactions on your behalf.

Easy data integration

Payers need only a basic ETL that provides member demographics, plan, accumulator and third-party information.

Grow as you go

Our per-member, per-month pricing has no transaction limits to make it easier to predict costs and avoid seasonal spikes.

Related healthcare insights

White paper

Unraveling complexity specialty care

Learn how Optum is streamlining care delivery with insights from patients and providers to improve outcomes and drive down costs.

Article

Defining the future of alternate-site infusion pharmacy care

Optum tackles the many issues infusion pharmacy care faces as it serves vulnerable patients with acute needs and complex conditions.

Case study

A case study on Excel Medical Center

Using digital integration to ease administrative burdens can help you spend more time with patients and deliver positive patient outcomes.

Current customer resources

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Product support

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Let’s start a conversation

We’re here to help you find out how our services could benefit your organization. Complete the quick form to the right, and someone will reach out to you soon.

Our experts will:

  • Discuss your individual use case and business needs
  • Explain our features, benefits and services
  • Show how this solution can help achieve your goals

Complementary solutions

EDI Network

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

Portals

Optum offers multiple portal options to fit the specific needs of your organization.

Payer Connectivity Services

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