Optum revenue cycle solutions help promote revenue integrity and productivity for hospitals and health systems. Our solutions combine 30+ years of medical coding industry experience with web-based tools to manage some of the most critical coding, billing and reimbursement elements within a hospital’s revenue cycle.
Successful claim reimbursement starts by setting up a complete and accurate service line and then establishing recurring maintenance.
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- CDM analysis: Automates more than 80% of the chargemaster review process
- Compliance: Efficiently flags potential coding and billing errors, lost revenue and compliance problems
- Pricing: Leverages data to help develop strategic pricing models
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- Coding and documentation: Access a complete library of medical coding content from Optum and other sources along with UB-04 billing tips
- Compliance: Search Part A and Part B LCD and NCD policies and more
- Claims and reimbursement: User-friendly tools drive accurate reimbursement
- Pricing: Access competitor data and Medicare reimbursement rates
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- Coding and documentation: Access essential FDA-approved drugs and related medical codes information
- Compliance: Search Part A and B LCD and NCD policies and more
- Pricing: Access drug pricing data and Medicare reimbursement rates
Chargemaster Advisory Support
- Challenges: Guidance to ensure up-to-date CDM best practices
- Policies: Guidance and suggestions on CDM policies (pricing, pharmacy, supplies, etc.)
- Changes: Quarterly conference calls to review the latest
1. “An ounce of prevention pays off: 90% of denials are preventable.” The Advisory Board Company, Dec. 11, 2014.
2. Hallock, John. “Change Healthcare Analysis: An Estimated $262 Billion in Healthcare Claims Initially Denied in 2016,” Change Healthcare Healthy Hospital Revenue Cycle Index, 26 June 2017. www.businesswire.com/news/home/20170626005391/en/Change-Healthcare-Analysis-Estimated-262-Billion-Healthcare
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