Change Healthcare (Optum) vs Experian Health
Two Claims & Clearinghouses vendors, side by side. Facts from public sources; judgments are ours.
At a glance
Derived from public facts · a rough scale, not a ranking
| Change Healthcare (Optum) | Experian Health | |
|---|---|---|
| Pricing model | Per-transaction / per-chart · Clearinghouse per-transaction fees | Enterprise contract (custom) · volume-based transaction and module pricing |
| Speed to go live | Payer enrollment and testing cycles | configured integration to EHR and payer rails |
| Automation model | Data / network utility · Largest claims clearinghouse network | Data / network utility · payer data network plus RCM tools |
| Built for | Enterprise systems, Payers, Billing companies, Mid-size groups | Enterprise systems, Mid-size groups, Billing companies |
| Security posture | HITRUST, HIPAA | HITRUST, HIPAA |
| Company maturity | 9 yrs (est. 2017) | 30 yrs (est. 1996) |
| Financial backing | Subsidiary of UnitedHealth Group (Optum) | Division of Experian plc (public, LSE: EXPN) |
| Named customers | None public | 1 named |
| Published results | No public numbers | Specific numbers public |
| Documented integrations | 5 listed | 4 listed |
| Third-party validation | None found | None found |
Bottom line
- Pick Change Healthcare if you need the broadest payer connectivity for claims, eligibility, and remits and can accept post-breach vendor concentration risk inside Optum.
- Pick Experian Health if you want a broad, proven RCM suite backed by payer connectivity and identity data from one vendor.
Change Healthcare (Optum)
The largest US medical claims clearinghouse, now part of Optum
- Founded
- 2017
- HQ
- Nashville, TN
- Stage
- Subsidiary of UnitedHealth Group (Optum)
- Raised
- n/a
What it does
- Medical, dental, and pharmacy claims clearinghouse
- Eligibility and benefits verification at scale
- Electronic remittance and payment services
- Claims editing and payment accuracy tools
- Clinical data exchange and attachments
- Patient billing and payment products
Where it's strong
- Unmatched payer connectivity: it remains the default clearinghouse route for a huge share of US claims volume.
- Breadth across medical, dental, and pharmacy transactions plus payments means one vendor can cover most exchange needs.
- Optum ownership gives it deep resources and long-term viability.
What buyers should weigh
- The February 2024 ransomware attack took its clearinghouse down for months, exposed data on roughly 192.7 million people, and cost UnitedHealth over $2B; restoration was not complete until late 2024 and litigation continues into 2026.
- Many providers now run a second clearinghouse for redundancy after the outage, and buyers should plan for the same.
- Being owned by UnitedHealth raises conflict-of-interest questions for providers and competing payers, and post-attack loan clawbacks strained provider trust.
Integrations
Experian Health
Patient access, coverage discovery, and claims tools from Experian
- Founded
- 1996
- HQ
- Franklin, TN
- Stage
- Division of Experian plc (public, LSE: EXPN)
- Raised
- n/a
What it does
- Real-time eligibility verification across 900+ payers
- Coverage Discovery finds billable insurance patients did not report
- Patient Access Curator fixes registration data in one inquiry
- Claims management, editing, and denials workflow
- Patient estimates and financial clearance
- Patient identity and demographic verification
Where it's strong
- Coverage Discovery is a category leader; Experian reports it found over $60B in billable coverage across 45M+ patient cases in 2024.
- Experian's consumer data assets give its eligibility and identity products signal most competitors lack.
- Financially stable public parent and one of the broadest patient access product lines on the market.
What buyers should weigh
- It is a portfolio of many products acquired over years, so expect separate modules and per-product pricing rather than one unified system.
- Primarily strong at the front end (access, coverage); some buyers pair it with a different clearinghouse or denials vendor.
- Implementation and tuning depend heavily on your EHR integration; ask for references on your specific system.
Named customers
Columbus Regional Health
Integrations
Compare against the rest of Claims & Clearinghouses
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