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Software

Rx Connect™ Solution

Our claims switch adjudication network allows pharmacies to send claims in real time to any U.S. third-party processor.

 

Link to third-party pharmacy payers

Use our solution to access an adjudication network for any third-party processor and deploy flexible, on-demand tools to support research, monitoring and service activity tracking.

Features include a high-speed intelligent network built to operate within existing pharmacy workflow and a security-focused network that supports infrastructure needs.

Secure claims routing to U.S. third-party processors

Switch claims

Switch claims in real time

A cloud-based platform improves flexibility, scalability, security and resiliency. Comprehensive services include claims processing and editing, real-time insurance verification, e-prescribing, medical and vaccination claims billing, and more.

Secure network

Operate on a secure network

Meet your specific infrastructure requirements with a variety of security-enabled connectivity options. Accreditation from Healthcare Network Accreditation Program (HNAP) and the Electronic Healthcare Network Accreditation Commission (EHNAC) supports compliance that exceeds industry established standards and HIPAA Privacy Rule regulations.

On-demand tools

Flexible, on-demand tools

Tools offer the ability to research, monitor, track and troubleshoot service activity for maximum efficiency and productivity. Innovative solutions include targeted messaging and electronic copay programs.

Industry insights

Empower Your D-SNP Strategy [E-book]

E-book

Empower your D-SNP strategy

How Optum Home & Community Care helps health plans align and advance.

Improving Care Outcomes With Compassion and Collaboration

Article

Care coordinator stories

The story of Kayla Perno, an Optum Care Coordinator, demonstrates how dedication to compassionate care leads to better outcomes.

Analytics in Action: Building a Strategic Framework for Risk Adjustment

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Analytics in action: Building a strategic framework for risk adjustment 

Explore how to harness the power of analytics to shape your 2026 risk adjustment strategy.

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