Cypress Care
Cypress Care, a subsidiary of Optum (UnitedHealth Group), delivers pharmacy benefit management, medical bill review, and state-certified managed care organization services for workers' compensation and auto no-fault claims, serving insurance carriers, TPAs, and self-insured employers through the VitalPoint portal and Tmesys 60,000-pharmacy network.
- Company typePrivate
- Founded2001
- HeadquartersEden Prairie, United States
- Headcount101–250
- GTM typeB2B
- OfferingServices
What Cypress Care does
Cypress Care, Inc. operates as a subsidiary of Optum, Inc., a wholly-owned subsidiary of UnitedHealth Group (NYSE: UNH), doing business as "Optum Workers' Compensation Services of Georgia." The company is one of five legal entities (alongside PMSI, Progressive Medical, Healthcare Solutions, and Procura Management) that collectively form the Optum Workers' Compensation and Auto No-Fault division. Cypress Care delivers pharmacy benefit management (PBM), medical bill review, utilization management, clinical oversight, ancillary services coordination, and state-certified Managed Care Organization (MCO) services to insurance carriers, third-party administrators (TPAs), and self-insured employers managing workers' compensation and auto no-fault claims. Headquartered within Optum's Eden Prairie, Minnesota campus, with operational correspondence routed through Huntingdon Valley, Pennsylvania, the company operates in the 101-250 employee range and is supported by 50+ years of legacy industry experience across the division.
The technology stack centers on three proprietary platforms: VitalPoint (the primary pharmacy and claims management portal), TruCase (case management system), and P2P Link (provider peer-to-peer connectivity platform). Underlying infrastructure includes the Tmesys pharmacy network (nearly 60,000 retail, home delivery, and specialty pharmacies), the Procura PPO network (provider access for auto no-fault), MicroStrategy-powered reporting within VitalPoint, One Healthcare ID (OHID) authentication, and a patent-pending clinical data analytics model developed by the Chief Clinical Officer that drives utilization management and fraud/waste/abuse detection. The VitalPoint portal underwent a major redesign in 2025. Certifications include URAC Gold accreditation, HIPAA compliance, NY 21 NYCRR 500 compliance, and state MCO certifications in California, Connecticut, Georgia, Illinois, Kentucky, New Jersey, New York, and West Virginia, with MAC disclosure processes across 20+ states.
Revenue is generated through transaction-fee PBM pricing on pharmacy claims, managed-care-services contracts for MCO functions, and ancillary service fees, all structured as multi-year enterprise B2B agreements with insurance carriers, TPAs, self-insured employers, and government entities. Go-to-market is enterprise field sales targeting large insurance carriers and national TPAs, supported by content marketing through the Policy Talk Podcast, CE-accredited continuing education webinars, a resource library, and active public policy and regulatory affairs engagement. The division serves 500,000+ injured persons annually with a reported 92% customer satisfaction rate and 15+ years of average industry experience among team members.
Cypress Care firmographics
Firmographics- Name
- Cypress Care
- Legal name
- Cypress Care, Inc.
- Website
- https://workcompauto.optum.com
- Company type
- Private
- Founded year
- 2001
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Cypress Care, a subsidiary of Optum (UnitedHealth Group), delivers pharmacy benefit management, medical bill review, and state-certified managed care organization services for workers' compensation and auto no-fault claims, serving insurance carriers, TPAs, and self-insured employers through the VitalPoint portal and Tmesys 60,000-pharmacy network.
- Ownership category
- akta.pro rank
Cypress Care industry classification
Industry- Product category
- Workers' Compensation and Auto No-Fault Managed Care Services
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Agencies, Brokerages, and Other Insurance Related Activities (5242)
- SIC
- Services-Health Services (8000), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Pharmacy Benefit Analytics, Reporting & Employer Consulting (HLAEAKAK)
- akta.pro secondary industries
- Pharmacy Benefit/Channel Services (PSAO, 340B Admin, Chargebacks/Rebates Ops) (CRAOAHAK), Pharmacy Liaison & Prior Authorization/Insurance Coordination (HSABALAD), Injectables & Specialty Medication Support (e.g., insulin, biologics) (HSABALAG)
Keywords
Where Cypress Care is headquartered
LocationHeadquarters
- HQ city
- Eden Prairie
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Cypress Care business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Pharmacy Benefit Management Services: PBM services for workers' compensation and auto no-fault claims including pharmacy network access, claims adjudication, drug formulary management, and utilization review. Revenue generated through transaction fees, per-claim processing, and contracted pricing arrangements with insurance carriers and TPAs.
- Managed Care Organization Services: State-certified managed care organization (MCO) services providing medical provider networks, utilization review, case management, and medical bill review. Revenue derived from contracted arrangements with employers, insurers, and TPAs.
- Ancillary Services: Clinical services, ancillary referrals, home delivery pharmacy, and specialized medical equipment coordination for injured workers and auto accident claimants.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Enterprise/B2B contracting (default) |
Go-to-market motion1 record
Distribution channels5 records
Marketing channels7 records
Cypress Care product offering
Product offeringCore offering
Cypress Care, Inc. provides pharmacy benefit management and state-certified managed care organization services for the U.S. workers' compensation and auto no-fault insurance markets. Core services include pharmacy claims adjudication and drug utilization review through the Tmesys pharmacy network (nearly 60,000 retail, home delivery, and specialty pharmacies), medical bill review, PPO provider network access via the Procura network, ancillary services coordination (home health, DME, transportation, diagnostic imaging), clinical oversight programs, and utilization management. The company contracts directly with insurance carriers, third-party administrators, self-insured employers, and government entities.
Product overview
Optum Workers' Comp and Auto No-Fault (which includes Cypress Care, Inc., dba Optum Workers' Compensation Services of Georgia) is a comprehensive platform providing integrated solutions for workers' compensation and auto no-fault insurance. The portfolio centers on three core components: pharmacy benefit management through the VitalPoint portal and Tmesys pharmacy network (nearly 60,000 pharmacies nationwide); medical and pharmacy bill review services; and a PPO network through the Procura Network for provider access. Ancillary services including home health, DME, transportation, and diagnostic imaging support injured persons. Clinical services encompass medication management, utilization review, and physician outreach. The offering also includes client-facing tools (VitalPoint, TruCase, P2P Link), continuing education programs, and policy insights through the Policy Talk Podcast. Cypress Care operates as part of this Optum division serving Georgia workers' compensation clients.
Differentiator
Problem solved
Functional benefit
Products and services
- Workers' Compensation Pharmacy Services End-to-end pharmacy benefit management for workers' compensation claims, including prescription processing, pharmacy locator, home delivery, and specialty pharmacy services for injured workers.
- Auto No-Fault Pharmacy Services Pharmacy benefit management for automobile no-fault claims, including prescription processing, pharmacy locator, and home delivery for policyholders in no-fault states.
- Tmesys Pharmacy Network National workers' compensation-specific pharmacy network of nearly 60,000 retail pharmacies plus home delivery and specialty pharmacies providing nationwide online claims submission and approval/processing for state and federal workers' compensation claims and select automobile no-fault / PIP claims.
- Procura Network Non-risk Preferred Provider Organization (PPO) network offering injured persons easy access to quality healthcare nationwide, available for both workers' compensation and auto no-fault lines of business through contracted providers.
- State-Certified Managed Care Organization (MCO) Services State-certified Managed Care Organization (MCO) services in California, Connecticut, Georgia, Illinois, Kentucky, New Jersey, New York, and West Virginia, providing compliant provider networks, utilization review, and case management for workers' compensation.
- Medical Bill Review Medical bill review services providing approval, repricing, and processing for workers' compensation and auto no-fault claims, including pharmacy bill review and broader medical bill review through the ProviderHub portal.
- Ancillary Services Comprehensive ancillary services including home health, durable medical equipment (DME), transportation, and diagnostic imaging referrals and management for injured workers and auto no-fault claimants.
- Clinical Services Clinical programs including medication plans, formularies, utilization reviews, physician outreach, clinical interventions, and pharmacist and nursing support to help manage medical costs and improve outcomes for injured workers and claimants.
- VitalPoint Portal Primary pharmacy portal providing online access for claims management, pharmacy transactions, reporting, and client services for workers' compensation and auto no-fault; available to claims professionals, providers, and clients.
- TruCase Case Management System Case management system for claims professionals providing integrated case handling, documentation, and workflow management for workers' compensation and auto no-fault claims.
- PPO Network Services Preferred Provider Organization network providing access to contracted healthcare providers with negotiated rates for workers' compensation and auto no-fault claims.
Quantifiable outcome
- 500,000+ injured persons currently served
- +3 more outcomes
Companies that use Cypress Care
Customer profileNamed customers3 records
Segments4 records
Ideal customer profiles3 records
Cypress Care technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration7 records
AI capability2 records
Feature4 records
Cypress Care partnerships and signals
Strategic signalPartnerships
Seven partnerships are on record, tiered core, regional and minor.
- Tmesys (Affiliate of Optum Rx)coreTmesys is a national, wholly-owned workers' compensation-specific network consisting of nearly 60,000 retail pharmacies, home delivery, and specialty pharmacies. It provides nationwide online claims submission and approval/processing for state and federal workers' compensation claims and certain automobile no-fault/personal injury protection claims in select states. Tmesys is an affiliate of Optum Rx, part of the Optum/UnitedHealth Group enterprise.
- Procura NetworkcoreThe Procura Network is a non-risk, PPO network for auto no-fault services that offers injured persons easy access to quality healthcare nationwide. The network includes providers dedicated to clinically appropriate care for injured persons.
- Anthem (California MPN Services)regionalOptum offers Medical Provider Network (MPN) services in California through affiliate partner Anthem, in alignment with Administrative Rules §9767.1-19. The MPN includes access to a comprehensive network of providers specializing in workers' compensation treatment.
- Networks by Design (California MPN Services)regionalOptum offers Medical Provider Network (MPN) services in California through affiliate partner Networks by Design, providing additional options for MPN coverage in alignment with California administrative rules.
- MagnaCare (New York Certified PPO Services)regionalOptum provides Certified Preferred Provider Organization (Certified PPO) services in New York through affiliate partner MagnaCare, in alignment with Administrative Regulations §325-8. Services include care coordination, utilization review, medical bill review, and dispute resolution.
- CEU InstituteminorCE credits for continuing education courses are administered by the CEU Institute, which handles accreditation and course completion reporting for Optum's CE webinar programs.
- Optum Health EducationminorOptum Health Education offers additional free online webinars and CE courses beyond the core Optum Workers' Comp and Auto No-Fault offerings, providing expanded continuing education opportunities.
Scale indicators6 records
Recent moves5 records
Expansion highlights4 records
Cypress Care competitors and assessment
Company assessmentBroad incumbents
- Express Scripts (Evernorth): Express Scripts, part of Cigna's Evernorth, is one of the largest U.S. PBMs serving commercial, government, and workers' compensation populations. It competes with Cypress Care for workers' comp PBM contracts at large carriers and TPAs.
- Enlyte (Coventry Workers' Comp Services): Enlyte (parent of Coventry, Mitchell, and myMatrixx) provides integrated workers' compensation managed care, PBM, and bill review services. As the consolidated owner of Mitchell and myMatrixx, Enlyte is one of the most directly competitive scaled platforms to Cypress Care.
- Magellan Rx Management: Magellan Rx Management, part of Centene, provides PBM, specialty pharmacy, and managed care services including utilization management and clinical programs — comparable to Cypress Care's clinical oversight and PBM service lines.
- MedImpact Healthcare Systems: MedImpact is an independent PBM providing pharmacy benefit management across commercial, Medicaid, and workers' compensation populations. It competes for workers' comp PBM contracts and offers comparable clinical oversight and formulary management capabilities.
- Optum Rx: Optum Rx is the broader PBM arm of Optum/UnitedHealth Group, providing commercial, Medicare, and specialty pharmacy benefit management. While Cypress Care sits within Optum, Optum Rx is the incumbent pharmacy platform against which all specialty/workers' comp PBMs compete for formulary, pricing, and network leverage.
Direct peers
- Helios (PBM): Helios is a specialty PBM focused on workers' compensation claims processing, clinical management, and pharmacy network services — directly comparable to Cypress Care's specialty workers' comp PBM offering for insurance carriers and TPAs.
- myMatrixx: myMatrixx by Enlyte is a pharmacy benefit manager purpose-built for workers' compensation and auto liability claims, offering claims processing, clinical management, and a national pharmacy network — competing head-to-head with Cypress Care/Tmesys.
- Healthesystems: Healthesystems is a specialty PBM and managed care services provider focused on workers' compensation, offering clinical programs, pharmacy network management, and claims processing — a directly comparable specialty workers' comp PBM peer.
- Mitchell International: Mitchell International provides claims management, pharmacy benefit management, and medical bill review solutions for workers' compensation and auto liability markets — directly competing with Cypress Care across PBM, bill review, and managed care services for carriers and TPAs.
Emerging players
- Sav-Rx: Sav-Rx is an independent PBM providing pharmacy benefit management services with a focus on cost containment and clinical programs. As a smaller PBM, it competes for workers' comp and commercial PBM contracts at a regional/tier-2 scale comparable to some Cypress Care customer segments.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
Cypress Care social profiles
Digital presenceCypress Care compliance and trust
Trust signalCompliance5 records
Cypress Care financial estimates
Financial estimateRevenue estimate
Valuation estimate
Cypress Care leadership team
Management profileNumber of profiles
Profiles1 record
Cypress Care funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Cypress Care M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Cypress Care
What does Cypress Care do?
Cypress Care, Inc. provides pharmacy benefit management and state-certified managed care organization services for the U.S. workers' compensation and auto no-fault insurance markets. Core services include pharmacy claims adjudication and drug utilization review through the Tmesys pharmacy network (nearly 60,000 retail, home delivery, and specialty pharmacies), medical bill review, PPO provider network access via the Procura network, ancillary services coordination (home health, DME, transportation, diagnostic imaging), clinical oversight programs, and utilization management. The company contracts directly with insurance carriers, third-party administrators, self-insured employers, and government entities.
Is Cypress Care a public or private company?
Cypress Care is a private company. It is classified as corporate owned and is currently operating.
When was Cypress Care founded?
Cypress Care was founded in 2001. It employs 101 to 250 people.
Where is Cypress Care based?
Cypress Care is headquartered in Eden Prairie, United States, in the North America region.
How does Cypress Care make money?
Three revenue lines are on record. Pharmacy Benefit Management Services are the primary driver. The others are managed Care Organization Services and ancillary Services.
Who are Cypress Care's main competitors?
Broad incumbents on record are Express Scripts (Evernorth), Enlyte (Coventry Workers' Comp Services), Magellan Rx Management, MedImpact Healthcare Systems and Optum Rx. Direct peers are Helios (PBM), myMatrixx, Healthesystems and Mitchell International. Sav-Rx is listed as an emerging player.
Does Cypress Care have an API?
No public API is recorded for Cypress Care.
What industry is Cypress Care in?
Cypress Care's product category is Workers' Compensation and Auto No-Fault Managed Care Services. Its primary akta.pro industry code is HLAEAKAK, Pharmacy Benefit Analytics, Reporting & Employer Consulting, with a secondary code of CRAOAHAK, Pharmacy Benefit/Channel Services (PSAO, 340B Admin, Chargebacks/Rebates Ops). Its NAICS code is 524292 and its SIC code is 8000.