Claim Appeal and Denial Support Add-on


List Price Per User
Single User

Item #: WA32
Available: NOW

In order to add this item to your cart, you must first add a qualifying item to your cart. See the list of qualifying items in the 'Description' tab below.

Watch the add-on modules product video.

The Claim Appeal and Denial Support Add-on provides, for any claim edit, the actual sourcing for that edit. For coders, this means no more searching for code guidelines for claims appeal support. Additionally, for each code, this tool provides information from Optum Evaluation and Management Coding Advisor and The Auditor’s Desk Reference books, as well as access to the Optum Lynx E/M Coding tool. All of these features and content arm the coder with information to avoid denials and evidence for effective appeals. The Lynx E/M code evaluation tool includes 2021 coding guidelines and logic.

NOTE: This item is an add-on to our suite of online products. This item may only be purchased online if you are also buying a new subscription to an online application. 

The Claim Appeal and Denial Support Add-on may be added to these online coding tools:

If you are already an active subscriber to one of our online coding applications and you are interested in purchasing an add-on, please contact a customer service representative at 1-800-464-3649, option 1.
  • Optum Edge — Sourcing information brings credibility to each claim edit in the Physician Compliance Editor feature ( Expert and for Payers). Each “scrubbed” claim now has industry standard coding guidelines that explain the coding errors identified on the claim. This claim edit information is essential when providing evidence for claim appeals for nonpayment. 
  • Optum Edge — Access to Optum Evaluation and Management code book data that is tied to each E/M code. This gives clarity to E/M coding which has been traditionally the most difficult and most often coded section of codes. Code E/M services at the right level and ensure that you have the most correct guidelines to support your E/M code selections. 
  • Optum Edge — Access to Optum E/M code evaluation tool. Updated for 2021, the E/M code evaluation tool now includes 2021 coding guidelines and logic. Users can select checkboxes to identify their history, exam and risk/complexity (medical decision making or time based levels), and the Optum E/M code evaluation tool will supply the correct code based on 1995, 1997 and 2021 E/M coding guidelines and logic.
  • Optum Edge — Access to Optum Auditors' Desk Reference code book content. Know, by code, what coding auditors evaluation when checking for correct coding. Understand those “hard to code” pitfalls and learn the correct coding to overcome common denials and coding mistakes.