Optum claims connectivity

Optum™ claims solutions are also designed to equip physician practices, health systems and hospitals with knowledge to keep pace with changing commercial, Medicare and Medicaid rules. This powerful knowledgebase is what sets these solutions apart and our clients always ahead of the knowledge and innovation curve.

Physician claims

”Optum Claims Manager has doubled the productivity of those who handle claims, and dramatically reduced our denial rates and A/R days. It has been able to do this even while we have added more complex claims to our mix.” — Kurt Paige, Director, Physician Business Services, St. Vincent Health

Optimize front-end processes to maximize reimbursement.

As physician practices contend with new regulatory requirements, including ICD-10, greater patient involvement and familiar financial pressures, timely and accurate billing and claims processing becomes more essential than ever to maintaining profitability. Optum™ billing and claims solutions and services can help your practice improve accuracy and productivity while streamlining workflows for optimal reimbursement.

Health systems and hospitals claims

Rules-based automation to boost first-pass payment rates.

Optum™ hospital claims solutions leverage advanced clinical editing to review inpatient and outpatient charges before payer claim submission. These advanced claims solutions can integrate within existing claim submission workflows with minimal disruption to your existing IT infrastructure. Our proven experience in helping hospitals correct errors before submission helps drive improve reimbursement rates, support claim and reimbursement compliance requirements, and reduce operating expenses.

Electronic payments and statements enrollment

Improve efficiency and cash flow with electronic payments and statements.

In addition to mounting administrative requirements, you need to manage billing and payment reconciliation for a rising number of patients who have deductibles and coinsurance obligations — or don’t have insurance at all. Electronic payments and statements (EPS) from Optum™ can help speed up the payment process and accounts payable reconciliation with health plans.