[oogali]

Change Healthcare is a transaction clearinghouse, or effectively an API, translation, and routing gateway.

Think of it as a private SWIFT vendor.

They were acquired by UHC, which is why you see the Optum name. But this is not specific to UHC/Optum patients.

Providers (hospitals, doctors, software vendors) interface with CH’s REST+JSON APIs and in turn CH emits EDI records to the insurance company backends (and translate the responses from EDI to JSON/XML/etc).

This affects general healthcare EDI messages (claims, benefits eligibility verification, ACH notices, etc).

The people impacted do not have direct EDI implementations with the insurance companies. If they did, they could side step this.

Or even a different clearinghouse.

Edit: clarified some ambiguous terms

[raffraffraff]

> The people impacted do not have direct EDI implementations with the insurance companies. If they did, they could side step this.

Thank you. I was trying to figure out how this company seemingly handles most of this stuff in the US.