OccuNet

What OccuNet does

The OccuNet Company is a privately held, family-owned healthcare cost containment firm headquartered in Amarillo, Texas, founded in 1998 and operating under Fairly family leadership. The company sells an integrated suite of three solutions — OccuNet (out-of-network claims repricing and negotiation for TPAs, payers, and health plans), Fairos (reference-based pricing health plans that replace or augment conventional PPO coverage), and FairosRx (a transparent pass-through pharmacy benefit manager) — supported by the proprietary OnPoint technology platform, which provides SOC 2-certified, HIPAA-compliant claims routing, contract applications, real-time analytics, and EDI/API integrations. Reported outcomes include 30%+ average employer healthcare cost reduction, a 74.7% historical average savings on out-of-network claims, 97.9% client retention, and 83.5 member NPS, alongside the Fairos Alliance network of 36,000+ direct provider agreements and 740,000+ unique provider locations across 12 states. Revenue is generated through a mix of transaction fees on repriced claims (OccuNet), per-member-per-month administrative fees and performance-based savings arrangements (Fairos), and per-prescription administrative fees on a pass-through PBM model (FairosRx). The company distributes primarily through direct enterprise field sales to self-insured employers and channel partnerships with TPAs, brokers, and stop-loss carriers, with HealthComp/BAS disclosed as a founding partner and preferred-vendor relationship serving over 30,000 members.

Name

OccuNet

Legal name

OccuNet, LLC

Website

https://occunet.com

Company type

Private

Founded year

1998

Operating status

Operating

Headcount range

101–250 employees

Short description

OccuNet is a privately held healthcare cost containment firm that delivers out-of-network claims repricing, reference-based pricing, and pass-through pharmacy benefit management to self-insured employers, TPAs, payers, and brokers via its proprietary OnPoint technology platform and Fairos Alliance provider network.

Ownership category

akta.pro rank

Product category

Healthcare Cost Containment Services

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Group Pharmacy Benefit (Rx) Coverage & PBM-Integrated Plans (FSAIAFAN)

akta.pro secondary industries

Insurance Claims Intake & FNOL Support (BPAAAFAA), Copay Assistance, Patient Support & Affordability Programs (HLAEAKAI)

Keywords

• Healthcare cost containment
• Reference-based pricing
• Pharmacy benefit management
• Out-of-network solutions
• Medical bill review

Headquarters

HQ city

Amarillo

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales

Revenue model

1. OccuNet Out-of-Network Solutions: Healthcare cost containment services for out-of-network claims, including bill review, medical contract negotiations, and repricing. Revenue generated through transaction fees on claims processed and negotiated savings.
2. Fairos Reference-Based Pricing: RBP solution for self-funded employer groups that replaces or enhances conventional PPO plans. Generates revenue through administrative fees per member per month and performance-based savings arrangements.
3. FairosRx Pharmacy Benefit Management: 100% pass-through PBM model where FairosRx returns 100% of all discounts or rebates directly back to clients. Revenue derived from administrative fees per prescription and pharmacy network arrangements.

Pricing tiers

Go-to-market motion2 records

Distribution channels6 records

Marketing channels8 records

Core offering

OccuNet is a healthcare cost containment company that provides out-of-network (OON) solutions, reference-based pricing (RBP), and pharmacy benefit management (PBM) services to self-insured employers, third-party administrators, payers, stop-loss carriers, brokers, and medical providers. Founded in 1998 and headquartered in Amarillo, Texas, the company delivers its services through a proprietary technology platform called OnPoint, and operates distinct service brands including Fairos (RBP), FairosRx (PBM), and the original OccuNet OON program for commercial, Taft-Hartley, accident & health, and workers' compensation lines of business.

Product overview

The OccuNet Company offers an integrated suite of three core healthcare cost containment solutions unified by its proprietary OnPoint technology platform: OccuNet (out-of-network solutions for TPAs, payers, and health plans), Fairos (Reference-Based Pricing that replaces PPO plans with Medicare-based benchmarks), and FairosRx (transparent Pharmacy Benefit Manager with pass-through pricing). The OnPoint OS powers all solutions with automated claims processing, real-time analytics, configurable workflows, and SOC 2/HIPAA-compliant security. Additional modules include Workers' Compensation cost containment, Accident & Health solutions, and Fairos Alliance high-performance provider networks. The integrated approach enables total cost tracking across medical and pharmacy claims with a single point of contact.

Differentiator

Problem solved

Functional benefit

Brands

• Fairos: Reference-Based Pricing (RBP) solution for self-funded employer healthcare that replaces or enhances conventional PPO plans.
• FairosRx
• OnPoint

Products and services

• OccuNet Out-of-Network Solutions (Commercial & Taft-Hartley) Out-of-network cost containment service for commercial and Taft-Hartley benefit plans that negotiates and reprices OON medical claims to reduce employer spend.
• OccuNet Accident & Health Out-of-network cost containment solution for accident and health insurance products, including limited benefit and supplemental plans.
• OccuNet Workers' Compensation
• Fairos Reference-Based Pricing Reference-based pricing service that sets reimbursement for medical claims against a transparent benchmark (commonly Medicare-based multiples) rather than PPO-discounted rates, with provider negotiation support.
• FairosRx Pharmacy Benefit Manager Pharmacy benefit management service that negotiates drug pricing, manages formularies, and processes pharmacy claims for self-insured plans and payers as part of the Fairos cost containment offering.
• Fairos Alliance Channel and partnership program that delivers Fairos reference-based pricing solutions to employers through brokers, consultants, and stop-loss carrier relationships.

Quantifiable outcome

• 30%+ reduction in annual employer healthcare costs
• +7 more outcomes

Named customers6 records

Segments6 records

Ideal customer profiles6 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

AI capability3 records

Feature5 records

Partnerships

Seven partnerships are on record, tiered minor, core and major.

• Ryan PalmerminorGTM or Marketing Partner · 19 February 2026Four-time PGA TOUR winner and Amarillo native Ryan Palmer serves as brand ambassador for The OccuNet Company. Palmer wears company logo on hat during 2026 competitions including the OccuNet Classic, and participates in select company engagements.
• Korn Ferry Tour / Framework Events / Tascosa Golf ClubcoreGTM or Marketing Partner · 27 October 2025Five-year partnership (2026-2030) to host the OccuNet Classic professional golf tournament at Tascosa Golf Club in Amarillo. The Korn Ferry Tour event brings the next generation of PGA TOUR stars to Amarillo, showcasing the company nationally and internationally while supporting the local community.
• Keegan Swenson and Sofia Gomez VillafaneminorGTM or Marketing Partner · 1 January 2025Professional gravel cyclists serve as brand ambassadors for Fairos healthcare solution. Sponsorship provides health benefits and highlights connection between gravel cycling's disruptive nature and Fairos' mission to simplify and reduce healthcare costs.
• Health Ohio Network (HON)majorStrategic or Co-development Partner · 26 March 2024Acquisition of Health Ohio Network expanding Fairos Alliance in the Midwest. The acquisition adds 109 hospitals, 2,500 facilities, and 81,000 providers to The OccuNet Company's provider network, enhancing Fairos Alliance solution across Ohio markets.
• Marty Joseph / HealthCompcoreStrategic or Co-development Partner · 12 March 2024Marty Joseph, founding member of HealthComp (formerly BAS), joins as EVP Strategic Partnerships. HealthComp established a RBP Center of Excellence that has served over 30,000 members. Fairos became HealthComp's preferred RBP partner, creating a preferred vendor relationship.
• West Texas A&M University - The Hill InstituteminorOthers · 1 February 2022Alex and Cheryl Fairly made the most significant family gift in WT's history to establish The Hill Institute, promoting core values through faculty and student involvement. The naming honors the Fairly family's contributions to WT's athletic program and the university.
• Learfield IMG College (Texas Tech, University of Texas, Texas A&M)coreGTM or Marketing Partner · 28 January 2021Multi-school athletics marketing partnership through Learfield IMG College providing hyper-targeted, co-branded advertising exposure to fans of Texas Tech, University of Texas, and Texas A&M. The partnership aims to raise awareness around employer healthcare cost challenges and position Fairos as a proven solution reducing employer healthcare costs by up to 30%.

Scale indicators14 records

Recent moves7 records

Expansion highlights6 records

Direct peers

• Zelis: Closest direct competitor offering integrated healthcare cost containment including claims repricing, network solutions, and PBM services. Multiple OccuNet executives (Tiago Gnanasekaran, Carol Lockwood) previously held senior roles at Zelis, and the two compete head-to-head for TPA and payer business.
• SmithRx: Transparent pass-through pharmacy benefit manager competing directly with FairosRx. Targets self-funded employers seeking alternatives to traditional PBMs with 100% pass-through rebate models similar to FairosRx.
• 6 Degrees Health: Reference-based pricing and healthcare cost containment solution for self-funded employers and TPAs. EVP Technology Tiago Gnanasekaran previously led product and technology teams at 6 Degrees Health, indicating direct competitive overlap.
• Vālenz Health: Integrated healthcare cost containment platform combining payment integrity, RBP, PBM, and provider network solutions for self-funded employers. Highly comparable business model to OccuNet's OccuNet/Fairos/FairosRx portfolio.
• Advanced Medical Pricing Solutions (AMPS): Direct competitor in reference-based pricing for self-funded employers and health plans. OccuNet's EVP of Sales Phil Valk previously led enterprise sales at AMPS, indicating direct head-to-head competition in the RBP space.

Regional players

• HealthComp Holdings: Third-party administrator and strategic channel partner of OccuNet (serving 30K+ members via Fairos RBP Center of Excellence). Functions as both customer/partner and indirect competitor in the TPA/cost-containment space.

Emerging players

• Capital Rx: Technology-driven transparent PBM with proprietary JUDI platform, competing against FairosRx in the innovation-led, pass-through PBM segment for self-funded employers.
• Navitus Health Solutions: Pass-through PBM providing transparent pharmacy benefit management to health plans, employers, and government programs. Competes with FairosRx in the transparent PBM market segment.
• RxBenefits: PBM partner for self-funded employer plans and TPAs, focused on transparent pharmacy benefit solutions. Competes with FairosRx in the employer/TPA channel for transparent PBM services.

Broad incumbents

• MultiPlan: Publicly traded incumbent offering claims cost management, network-based solutions, and data analytics for payors, TPAs, and self-funded employers. Competes with OccuNet's out-of-network repricing and bill review services at greater scale.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/OccuNet-100710298586052
• LinkedInlinkedin.com/company/occunet
• Xx.com/OccuNet

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles20 records

Subsidiaries1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about OccuNet