CHANGE HEALTHCARE OPERATIONS, LLC

Change Healthcare Operations, LLC specializes in delivering mission-critical healthcare claims processing, eligibility verification, and electronic data interchange (EDI) solutions for federal health programs. Their core capabilities center on pharmacy benefit management systems, point-of-sale billing platforms, and clearinghouse services that enable seamless electronic submission of pharmaceutical claims between providers, payers, and government entities. The contractor develops and operates secure, compliant software systems that support real-time insurance verification, benefit eligibility checks, and claims routing—primarily serving Indian Health Service, Veterans Affairs, and other HHS components. Technical expertise includes EDI P2E and PIMC protocols, RPMS integration, and interoperable pharmacy information systems built to meet HIPAA and HITECH standards. Their solutions are tailored for high-volume, low-latency environments where accuracy and regulatory compliance are non-negotiable. The contractor maintains a deep, sustained relationship with the Department of Health and Human Services, delivering pharmacy claims infrastructure and eligibility services across tribal, federal, and veteran-facing healthcare networks. They also support the Department of Veterans Affairs with revenue transaction and EDI services that underpin clinical and financial workflows. Their work consistently aligns with HHS’s mission to modernize decentralized healthcare billing systems and ensure equitable access to pharmaceutical benefits. Their primary industry focus is software publishing for healthcare IT, with a specialization in pharmacy and insurance administration systems. While they provide computing infrastructure services, their distinct positioning lies in domain-specific applications that bridge clinical, financial, and administrative workflows in public health ecosystems. Change Healthcare Operations, LLC is a Tennessee-based limited liability company with no federal certifications on record. They operate as a specialized vendor within the federal healthcare technology market, focusing exclusively on technical solutions for government health programs without broader commercial or enterprise-scale offerings.