ACPN
ACPN operates a national multispecialty healthcare provider network using proprietary automated claims repricing technology, serving insurance carriers, third-party administrators, employer groups, and other payers across the United States and select international markets.
- Company typePrivate
- Founded2012
- HeadquartersFarmington Hills, United States
- Headcount11–50
- GTM typeB2B
- OfferingServices
What ACPN does
ACPN (America's Choice Provider Network) is a privately held healthcare technology company founded in 2012 and headquartered at 8060 S. Kyrene Road, Suite 100, Tempe, Arizona. The company operates an independent, multispecialty national provider network serving three constituencies in healthcare transactions: providers, payers, and patients. Payers access ACPN's contracted network at pre-determined reimbursement rates; providers join the network free of charge; and patients gain broader in-network access through their plan's relationship with ACPN. Geographic reach spans all 50 U.S. states plus Canada, Dominican Republic, Guam, Mexico, and Puerto Rico, with member coverage referenced at 28 million lives through payer relationships.
The core of ACPN's offering is its proprietary "Perfect Repricing Process," a software application that performs fully automated medical claims repricing without human intervention and without assigning "pending" status. This engine is exposed through three product surfaces: QuickPrice (an SSL-secured web portal that returns repricing sheets instantaneously), a Provider Portal for credentialing and resource access, and an Online Provider Directory searchable by specialty, provider type, and state. The platform supports HIPAA-compliant EDI 837 batch file formats, real-time XML interfaces, and CSV/flat file formats, enabling touchless claims exchange between ACPN and payer clients.
ACPN's commercial model is a transaction-fee structure paid by payer clients for network access and claims repricing; provider participation is permanently free. Go-to-market combines enterprise direct sales to insurance carriers, third-party administrators, health and welfare funds, self-administered employer groups, student plans, and travel plans, supplemented by self-serve channels through QuickPrice and the Provider Portal. The company has executed more than 20 documented partnerships since 2012, with a heavy weighting toward specialty diagnostics and therapy networks between 2015 and 2021. No revenue, funding, or leadership team disclosures are present in the source data.
ACPN firmographics
Firmographics- Name
- ACPN
- Legal name
- America's Choice Provider Network
- Website
- https://acpnusa.com
- Company type
- Private
- Founded year
- 2012
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- ACPN operates a national multispecialty healthcare provider network using proprietary automated claims repricing technology, serving insurance carriers, third-party administrators, employer groups, and other payers across the United States and select international markets.
- Ownership category
- akta.pro rank
ACPN industry classification
Industry- Product category
- Healthcare Provider Network Services
- NAICS
- Insurance Agencies and Brokerages (524210)
- SIC
- Services-Computer Programming, Data Processing, Etc. (7370)
- akta.pro primary industry
- National PPO Networks (HLAEANAA)
- akta.pro secondary industries
- Reference-Based Pricing (RBP) / PPO Alternative Networks (HLAEANAL), Provider Network, Credentialing & Contracting Support (BPAAAFAI), Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)
Keywords
Where ACPN is headquartered
LocationHeadquarters
- HQ city
- Farmington Hills
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
ACPN business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Technology or R&D, Personnel, Operations, Marketing or Sales, Infrastructure
Revenue model
- Network Access and Repricing Services: ACPN generates revenue by providing healthcare payer clients access to their national network of providers at pre-determined reimbursement arrangements. Claims are exchanged electronically with clients, with ACPN applying contracted reimbursement rates and returning claims to payers for remittance.
- Provider Network Participation: Provider participation in the network is free. Revenue is generated from payer client engagements rather than provider fees.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Freemium | Others | Provider Network Participation - Free |
Go-to-market motion2 records
Distribution channels4 records
Marketing channels6 records
ACPN product offering
Product offeringCore offering
ACPN operates an independent national multispecialty provider network that contracts directly with healthcare providers and grants payer clients access to pre-determined reimbursement arrangements. Claims are exchanged electronically with payers, and ACPN applies contracted rates and returns claims for remittance using its proprietary "Perfect Repricing Process" software and the QuickPrice web portal. Provider participation is free, and the network covers all 50 U.S. states, Canada, Dominican Republic, Guam, Mexico, and Puerto Rico.
Product overview
ACPN offers a unified platform centered on its proprietary Perfect Repricing Process technology, which provides fully automated medical claims processing. The platform includes QuickPrice for real-time web-based claims processing, an Online Provider Directory for network searching, and a Provider Portal for credentialing and resource access. Together, these products enable automated, touchless claims adjudication for providers, payers, and patients across the ACPN national network.
Differentiator
Problem solved
Functional benefit
Brands
- QuickPrice: Proprietary web application for payers to process claims via SSL secured Web Portal for automated medical claims repricing.
- Perfect Repricing Process
Products and services
- Perfect Repricing Process Proprietary software application that enables fully automated processing of medical claims without human touch; all claims are processed in full and never assigned a 'pending' status. The product underpins ACPN's claims repricing services for payers and providers.
- QuickPrice SSL-secured proprietary web application that enables payers to process claims via an online portal, supporting both automated processing and manual entry from HCFA or UB claim forms, and returning a repricing sheet instantaneously for payment and documentation.
- Provider Portal Online portal for participating providers to access payer listings, submit demographic updates, view client lists, and access reference guides, hosted at providers.acpnusa.com.
- Online Provider Directory Web-based searchable directory allowing patients and providers to locate healthcare providers by specialty, provider type (Facility or Physician), and state across the ACPN network.
- National Provider Network Access Core network access service providing payer clients with access to a multispecialty provider network across all 50 U.S. states, Canada, Dominican Republic, Guam, Mexico, and Puerto Rico at pre-determined reimbursement arrangements, supporting Individual and Group Health, Workers Compensation, Auto Liability, and Medicare Advantage products.
Quantifiable outcome
- 30-day guaranteed reimbursement for providers
- +2 more outcomes
Companies that use ACPN
Customer profileNamed customers6 records
Segments3 records
Ideal customer profiles2 records
ACPN technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature4 records
ACPN partnerships and signals
Strategic signalPartnerships
24 partnerships are on record, tiered core.
- Scipher MedicinecorePartnership announced November 2021 for providing patients access to Scipher Medicine's healthcare solutions through the ACPN national provider network.
- PreludeDXcorePartnership announced November 2020 to expand access to PreludeDX diagnostics and services through the ACPN network.
- RenalytixAIcorePartnership announced August 2020 to provide access to RenalytixAI's kidney intelligence platform through the ACPN network.
- OncimmunecoreAgreement to expand access to Oncimmune's blood tests for early detection through the ACPN network.
- Exosome DiagnosticscoreAgreement expanding access and coverage for EPI (Exosome Plus) to 28 million member network in the US.
- Life Line Community HealthcarecorePreferred provider network agreement to expand healthcare access through the ACPN network.
- MDxHealthcorePartnership securing first reimbursement coverage for SelectMDx prostate cancer test through ACPN.
- Rennova HealthcorePreferred provider network agreement to expand access to Rennova Health services.
- Interpace DiagnosticscoreAgreement to cover all molecular tests for thyroid and pancreatic cancer through ACPN network.
- Rosetta GenomicscoreAgreement for entire suite of diagnostic tests and services through ACPN network.
- Med GroupcoreExpansion of payer network with addition of ACPN for Med Group clients.
- Armune BioSciencecoreContract secured for APIFINY with ACPN to expand access to APIFINY cancer detection tests.
- TrovagenecoreAgreement to offer patients access to Trovagene's ctDNA precision cancer monitoring platform.
- Preferred Therapy ProviderscoreNational partnership for therapy provider network access through ACPN.
- Signal GeneticscorePartnership expanding reimbursement of MyPRS (myPRS/MyPRS Test) genetic testing through ACPN.
- PTPNcoreNational partnership with PTPN (Provider Time Performance Network) for therapy provider access.
- Cancer Genetics InccoreAgreement to increase access to comprehensive cancer diagnostic tests and services through ACPN.
- Physicians Choice LaboratorycorePartnership expanding laboratory testing access through the ACPN network.
- BioceptcorePartnership to offer Biocept's proprietary oncology diagnostics on ACPN network.
- CombimatrixcoreContract to provide access to Combimatrix diagnostics through ACPN network.
- Response Genetics InccoreNew contract to expand access to Response Genetics diagnostics through ACPN.
- Pacific EdgecoreAgreement to expand access to Cxbladder diagnostic test in the US through ACPN network.
- MDXHEALTHcoreInsurance agreements expanding access to ConfirmMDx for prostate cancer test through ACPN.
- HNA (Health Network Authorization)corePatient contract signing to provide HNA patients access to ACPN provider network.
Scale indicators3 records
Recent moves7 records
Expansion highlights4 records
ACPN competitors and assessment
Company assessmentDirect peers
- MultiPlan: MultiPlan is the largest independent PPO network in the US, offering provider network access, repricing, and cost management services to payers, TPAs, and self-funded plans. It competes head-on with ACPN in the national provider network and claims repricing category.
- Zelis Healthcare: Zelis provides healthcare cost management, including provider network access, claims repricing, and payment integrity solutions. It serves insurance carriers, TPAs, and self-funded employer plans in the same buyer segments ACPN targets.
- First Health Network: First Health Network is a national PPO network offering providers, payers, and self-funded employers access to discounted healthcare services. Its model of contracted reimbursement rates aligns directly with ACPN's national provider network and repricing approach.
- Beech Street Corporation: Beech Street operates a national PPO/network serving payers, TPAs, and self-insured employer groups with contracted reimbursement rates. It is a directly comparable competitor in the national provider network and repricing space.
- PHCS (Private Healthcare Systems): PHCS, a MultiPlan subsidiary, is a national PPO network serving employers and payers. Like ACPN, it focuses on contracted-rate provider access and claims repricing for self-funded and small-group health plans.
- HealthSmart (formerly Wells Fargo Insurance): HealthSmart provides provider network access, claims processing, and utilization management to self-funded employer groups, TPAs, and insurers. It is comparable in targeting the same payer segments with similar repricing and network services.
Broad incumbents
- Change Healthcare (Optum): Change Healthcare (acquired by Optum) operates a broad portfolio of healthcare network, claims processing, and interoperability services. It overlaps with ACPN's EDI 837-based claims exchange and payer-provider data exchange functions at much greater scale.
- Evicore (eviCore healthcare): EviCore, now part of Elevance Health, provides utilization management and network solutions for specialty care, diagnostics, and advanced imaging. ACPN's diagnostic-partnership model (Scipher, RenalytixAI, PreludeDX) overlaps with how EviCore channels specialty services to payers.
- UnitedHealthcare (Optum Health): UnitedHealth/Optum is the largest US health insurer and operates one of the broadest proprietary provider networks. ACPN effectively competes for the same payers and employer self-funded plans, but Optum bundles network access with insurance, claims, and analytics at scale.
- Cigna Healthcare (Evernorth): Cigna/Evernorth operates one of the largest national provider networks, alongside insurance products and pharmacy benefit management. ACPN competes for the same payer clients, particularly TPAs and self-funded employers, who can route through Cigna's network as an alternative to ACPN.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat4 records
Key risks5 records
Key highlights6 records
Customer concentration
ACPN social profiles
Digital presenceACPN compliance and trust
Trust signalCompliance1 record
ACPN financial estimates
Financial estimateRevenue estimate
Valuation estimate
ACPN leadership team
Management profileNumber of profiles
Profiles1 record
ACPN funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
ACPN 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 ACPN
What does ACPN do?
ACPN operates an independent national multispecialty provider network that contracts directly with healthcare providers and grants payer clients access to pre-determined reimbursement arrangements. Claims are exchanged electronically with payers, and ACPN applies contracted rates and returns claims for remittance using its proprietary "Perfect Repricing Process" software and the QuickPrice web portal. Provider participation is free, and the network covers all 50 U.S. states, Canada, Dominican Republic, Guam, Mexico, and Puerto Rico.
Is ACPN a public or private company?
ACPN is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was ACPN founded?
ACPN was founded in 2012. It employs 11 to 50 people.
Where is ACPN based?
ACPN is headquartered in Farmington Hills, United States, in the North America region.
How does ACPN make money?
Two revenue lines are on record. Network Access and Repricing Services are the primary driver. The others are provider Network Participation.
Who are ACPN's main competitors?
Direct peers on record are MultiPlan, Zelis Healthcare, First Health Network, Beech Street Corporation, PHCS (Private Healthcare Systems) and HealthSmart (formerly Wells Fargo Insurance). Broad incumbents are Change Healthcare (Optum), Evicore (eviCore healthcare), UnitedHealthcare (Optum Health) and Cigna Healthcare (Evernorth).
Does ACPN have an API?
No public API is recorded for ACPN.
What industry is ACPN in?
ACPN's product category is Healthcare Provider Network Services. Its primary akta.pro industry code is HLAEANAA, National PPO Networks, with a secondary code of HLAEANAL, Reference-Based Pricing (RBP) / PPO Alternative Networks. Its NAICS code is 524210 and its SIC code is 7370.