Solution Bundle

Payer Connectivity Services

A claims administration, routing, and first-pass adjudication system for payers and TPAs that want to consolidate and manage their inbound and outbound transaction streams at a single connection point.


ImproveHealth Plan Success

  • Increase first-pass adjudication rate by using standard SNIP edits, as well as advanced custom edits.

  • Consolidate EDI transaction streams to simplify the claims administration process.

  • Enhance provider experience with portal research functions and metrics to proactively reduce common provider errors.
  • Reduce administrative waste across a health plan’s claims, operations, network management, and EDI departments.

  • Streamline transaction processing across multiple claim systems and lines of business with advanced transaction routing.

  • Simplify regulatory compliance (CORE Phase I, II, III and HIPAA 5010 compliant) and all standard HIPAA transactions (837, 835, 270/271, 276/277/277CA, 278, 820, 834, 835, 999/TA1).

Enable High-Quality, Effective Transaction Management

  • A single transaction workflow solution

    • Provides a single connection point for transactions, helping enable industry standard and payer-specific business rules and compliance with legislative mandates.
    • Simplifies the claims administration process, consolidating submitters and reducing administrative complexity so it’s easier for providers, payers and administrators to work together.
    • Improves claims routing accuracy and reduces claim rework. With the ability to route transaction data to the appropriate processing path, you can simplify transactional workflows - even one with multiple claims systems and lines of business.
  • Advanced claims edits and routing

    • Applies advanced claims edits and presents edit errors directly to submitters to catch errors up-front in processing so claims can be made cleaner when routed for processing.
    • Simplifies compliance with federal regulations, HIPAA, and CORE Phase I, II and III for ACA Operating Rules.
    • Reduces administrative waste stemming from low first-pass rates and claim rework due to incorrect routing across multiple adjudication systems.

Our outcomes

View all insights


Need support for
this solution?

Join Community discussions

Find and share knowledge, exchange ideas, and collaborate with peers and Change Healthcare experts to drive your solutions to success.

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

Want more information about our services? Start here.

Thank You

We appreciate your interest in Change Healthcare. A member of our team will contact you to better understand your needs and discuss potential solutions.

Together, we are accelerating the journey toward improved lives and healthier communities.