Coding at its core | Optum360

It can be challenging to stay up to date with frequent code changes, regulatory updates, various guidelines and more. Optum360® helps physicians stay compliant and increase coding accuracy with a wide array of products..

Starting with EncoderPro.com, you can pair other products to fulfill your coding, billing and reimbursement referential content needs in one place. We also offer a customized EncoderPro.com for Payers version designed specifically to meet the needs of payer organizations.


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Improve coding accuracy and compliance

Proprietary content and features that go beyond code updates

Encoderpro.com is a web-based application designed to manage some of the most critical ambulatory coding, billing and reimbursement elements.

With EncoderPro.com, you can dive deeper into complex regulatory compliance topics, such as Hierarchical Condition Categories (HCCs), National Correct Coding Initiative (NCCI) edits and local and national coverage determination (LCD and NCD) policies for medical necessity. EncoderPro.com Expert provides ambulatory practices, with an efficient way to check your work by running selected codes through an automated edit review to ensure proper unbundling, correct modifiers, complete diagnoses and more, prior to submittal to a clearinghouse/vendor/payer. It also includes access to a 24-month historical content database for use during claim adjudication.

Specialized software eases the burden of setting defensible fee schedules

FeeAnalyzer.com makes it easier for physicians to set defensible fees while maximizing revenues.

FeeAnalyzer.com data is updated throughout the year to ensure you have immediate access to the most current information available. This powerful data source is an online subscription service that provides access to relative and actual physician charge data*, compiled by FAIR Health, Inc., for services in specific geographic areas, based on geographic location (geozip). In addition, it includes national charge data for HCPCS Level II codes — these are the aggregated fees your competition is charging. Medicare fee schedules are also integrated for a complete perspective.

Physician-based claims submission, education and coding reference resources boost productivity

Claim Appeal and Denial Support Add-on – Provides claims edit sourcing documentation within the Compliance Editor to assist with claim appeal support, access to the Optum360 Evaluation and Management Coding Advisor and the Auditor’s Desk Reference books as well as access to the Optum® LYNX E/M coding tool.

  • Claims Batch Editor Add-on — Boost productivity by running a batch of claims through the EncoderPro.com Compliance Editor for code edits. 
  • EncoderPro.com Plus Add-on — Provides specialty-relevant search capability, access to web-based education, worth 25 continuing education units (CEUs), and the Optum LYNX E/M coding tool to help with proper E/M code assignment
  • Clinical Documentation Improvement Add-on — Provides access to proprietary content from four Optum360 books: ICD-10-CM Clinical Documentation Improvement Desk Reference, Guide to Clinical Validation Documentation and Coding Reference, Physician Consulting ICD-10-CM CDI Improvement Training Content and Clinical Documentation Guidelines for Facilities. This content, organized by code, helps ensure clinical quality, substantiates medical necessity and aids in justification for appropriate reimbursement. Health record documentation as designated by the clinician is the foundation upon which coding decisions are based.
  • Optum360 Specialty Articles Add-on — Access a proprietary Optum360 content database of more than 2,500 specialty newsletter articles that will help you explore specialty nuances and assist with accurately coding unique specialty situations.
  • AMA CPT® Content Module Add-on — Offers unparalleled access to CPT®-associated content delivered by the AMA to provide clarity and accuracy in CPT® code reporting. Gain complete access to the CPT® Assistant newsletters, CPT® Changes: An Insider’s View publication, and access thousands of answers to questions from the AMA’s extensive knowledge base of customer-asked CPT® code inquiries.
  • AHA Coding Clinic® for ICD/HCPCS Add-on — Provides a complete archive of the ICD/HCPCS coding clinics to support you in assigning the most appropriate code to help avoid claim denials and assist with various research projects.


Physician-based tools offered:

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Explore these helpful resources

BROCHURE: PHYSICIAN-BASED COMPLETE MEDICAL CODING REFERENTIAL CONTENT

Download an easy to print version of this page.

PRODUCT VIDEO: ENCODERPRO.COM

This short product video highlights the features and benefits of EncoderPro.com.

BROCHURE: ENCODERPRO.COM HAS PROVIDED SUPPORT TO CODERS FOR MORE THAN 20 YEARS

This one-page document showcases how EncoderPro.com has evolved over the years and the features most utilized by clients.

PRODUCT VIDEO: FEEANALYZER.COM

This short product video highlights the features and benefits of FeeAnalyzer.com

CLIENT FEEDBACK: ENCODERPRO.COM

See what our clients are saying about EncoderPro.com with this one-page download.

WEBINAR: IMPROVE CODING ACCURACY AND IMPACT CODING-RELATED DENIALS USING ENCODERPRO.COM

Join us as we walk through claim tools and content within EncoderPro.com.This webinar will review the Auditor’s Desk Reference and Evaluation and Management Coding Advisor print book content, compliance editor tool and more, to show how this tool impacts your practice’s claims process.


CPT is a registered trademark of the American Medical Association.

Coding Clinics is a registered trademark of the American Hospital Association.

*Data only © 2021 FAIR Health, Inc.