Improve payment accuracy without amplifying abrasion
As medical claim costs continue to grow, health plans are challenged to deliver cost savings without amplifying member and provider abrasion. We offer a suite of fully integrated, end-to-end solutions that help health plans effectively and efficiently manage medical expense.
Available both pre- and post-payment, Optum® Payment Integrity solutions improve payment accuracy at every point in the claim lifecycle while reducing the administrative burden on providers.
Key benefits
Our suite of Payment Integrity solutions can help you achieve 8%-10% medical cost savings annually.
Industry-leading content and analytics
Our expansive content and analytic libraries enable more precise claim selection and help you address emerging drivers of medical expense.
Improve the provider experience
Our digital-first tools and educational resources reduce the burden of managing billing errors and medical record requests for providers.
Shift to prevention
We’re working directly with providers to build transparency, simplify reimbursement and prevent avoidable denials.
Payment Integrity solutions
Coding Advisor
Claim Pricing solutions
Claims Edit System
Claim Review
Coordination of Benefits
Subrogation for health plans
Credit Balance resolution services
Optimize your payment integrity program
Optimize your payment integrity program with our Comprehensive Payment Integrity Assessment. Our team of experts will analyze your current program to identify gaps and opportunities for improvement, providing you with a strategic roadmap to modernize your payment integrity office and increase medical spend savings.
Related healthcare insights
E-book
Learn how to create a framework that drives payment accuracy on the first pass.
Video
Learn how a flexible editing program can help your plan solve editing challenges, enforce policies, improve accuracy and increase savings.
