Change Healthcare (Optum) vs Stedi
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) | Stedi | |
|---|---|---|
| Pricing model | Per-transaction / per-chart · Clearinghouse per-transaction fees | Per-transaction / per-chart · Published pay-as-you-go rates, volume tiers, no minimum |
| Speed to go live | Payer enrollment and testing cycles | Self-serve signup, your developers integrate the API |
| Automation model | Data / network utility · Largest claims clearinghouse network | Data / network utility · API-first clearinghouse |
| Built for | Enterprise systems, Payers, Billing companies, Mid-size groups | Billing companies, Enterprise systems, Payers |
| Security posture | HITRUST, HIPAA | SOC 2 Type II, HIPAA |
| Company maturity | 9 yrs (est. 2017) | 9 yrs (est. 2017) |
| Financial backing | Subsidiary of UnitedHealth Group (Optum) | $142M · Series C |
| Named customers | None public | 5 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 Stedi if you have engineers and want a modern clearinghouse API with transparent per-transaction pricing you can start testing today.
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
Stedi
API-first clearinghouse for developers
- Founded
- 2017
- HQ
- New York, NY
- Stage
- Series C
- Raised
- $142M
What it does
- Real-time eligibility checks via JSON API (270/271)
- Insurance discovery when patient coverage is unknown
- Claim submission and claim status via API (837/276)
- Electronic remittance advice (ERA) retrieval
- Payer transaction enrollments managed programmatically
- Batch eligibility checks at high volume
Where it's strong
- Everything is accessible via API with public docs and transparent self-serve onboarding, which legacy clearinghouses like Availity and Optum do not offer.
- Support is unusually fast for the category, with a median ticket response under seven minutes across 1,500+ shared support channels.
- Well capitalized ($142M raised, backed by Stripe and Addition) with rapid traction: paying customers up 6x and billed transactions up 7x year over year into 2026.
What buyers should weigh
- It is clearinghouse rails, not a billing service; you need engineers to build eligibility and claims workflows on top of it.
- Its direct payer network is younger than Availity's or Optum's, so some connections still route through intermediary partners.
- The company only pivoted from general-purpose EDI to healthcare around 2023, so its healthcare-specific track record is short.
Named customers
Pair Team · Tennr · Candid Health · Nirvana · Berry Street
Integrations
Compare against the rest of Claims & Clearinghouses
Deciding between these two?
First Pass tracks Claims & Clearinghouses every week: funding, launches, and what changed since this page was written.