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
White paper
New research examines how structured, nurse‑led case management influences cost, utilization and outcomes for members undergoing complex organ transplants.
On-demand webinar
As transplant, cell and gene therapies grow in complexity, payers need new approaches to manage cost, risk and support long-term sustainability.
![Closing Clinical Handoff Gap in Post‑Acute Care [White Paper]](/content/dam/optum-dam/images/business/insights/clinician-hugging-patient-1080x720.jpg)
White paper
Incomplete, backward-looking information during care transitions drives avoidable utilization. Learn why MA plans must focus on the handoff, not just readmissions.
Complementary solutions
Software
Rx Edit
A comprehensive pharmacy claim solution designed to increase third-party reimbursements and improve in-store productivity.
Software
Rx CardFinder Services
A pharmacy eligibility service that checks patient coverage with the nation’s largest pharmacy benefit managers and returns real-time responses.
Software
Rx Assist
Our dynamic copay assistance and messaging platform helps deliver real-time prescription savings and educational messaging to patients.