Helping state Medicaid professionals stay compliant through collaboration.
We partner with state agencies, healthcare providers, and trusted vendors to improve program transparency and compliance. Our platform identifies coverage risks early, streamlines renewal processes, and helps keep benefits active—reducing financial losses and strengthening care continuity.
Complex healthcare workflows
made simple
Intelligent scheduling
Automate proactive outreach based on coverage end dates, address changes, or real-time eligibility loss—so no patient falls through the cracks.
Multi-channel outreach
Contact patients through their preferred channels—phone, email, SMS—to secure re-enrollment before coverage lapses.
Conditional logic
Automatically guide through the correct Medicare enrollment pathway, including Special Enrollment Periods triggered by qualifying life events.
Smart notifications
Real-time alerts for coverage changes, with pre-populated forms ready for revalidation or reactivation.
Workload balance
Assign reactivation cases to the right team members to maximize efficiency and speed.
Complete visibility
A unified dashboard showing the status of every Medicare (and dual-eligible) patient, from first alert to successful coverage reinstatement.
OptimSync is designed to connect seamlessly with a wide range of systems used by covered entities and pharmacies. We integrate with Pharmacy Management Systems (PMS) such as Pioneer, QS/1, and PioneerRX, Electronic Health Records (EHR) like Epic, Cerner, Allscripts), and NextGen, Wholesaler and manufacturer portals such as McKesson, Cardinal, AmerisourceBergen, and many others. If you have a unique system not listed, our integration team can build custom connections to fit your workflow.
Most OptimSync clients are fully onboarded and operational within 2-4 weeks. Timelines can vary based on the complexity of your setup, the number of integrations required, and the responsiveness of your team. We guide you through every step—from data connections to training—so you can start seeing results as quickly as possible.
OptimSync's compliance framework is built on SOC 1 and SOC 2 standards, guided by NIST SP 800-53 controls and aligned with ISO 27001 best practices. We safeguard data with strict access controls, encryption, and continuous monitoring. Our platform maintains complete audit trails and transparent workflows, helping covered entities and pharmacies remain fully audit-ready and aligned with federal and state regulatory requirements.
Absolutely. OptimSync uses bank-grade encryption, secure cloud infrastructure, and strict access controls to protect all patient and pharmacy data. Our security program follows SOC 1 and SOC 2 standards and incorporates best practices from ISO 27001 and NIST SP 800-53. We also meet all HIPAA requirements to ensure data privacy and confidentiality at every step.
Absolutely. Our analytics uncover undiscovered savings, missed eligibility matches, and revenue opportunities, helping you get the most from your 340B program.
We focus on transparency, automation, and actionable insights. You own your data, have full visibility into every claim, and can access real-time reporting anytime.
Tech-enabled
clarity for states
Your team works tirelessly to stay compliant and make the 340B program deliver for patients. OptimSync makes it easier.
Dedicated team for state payers
Rely on our expert team of state payer specialists, who will work directly with you to ensure you get the support you need.
Easy-to-use dispute reports
Streamline the dispute process with simplified reports that have all the necessary information in one place.
Uphold program guidelines
Expedite the good faith inquiry process and validate your findings with easy-to-use tools.
Time reclaimed. Patients
helped found
Minutes
Configuration
Not Month Of IT
95%
Task Completion VS
40% Manual
100 X
Scale Achieved
Patient Capacity
37 X
Response Time
Faster Resolution
Want to learn more
about OptimSync?
Discover how OptimSync can enhance your health care experience. Streamline your processes and improve patient outcomes with our innovative solutions.