Reduce low-dollar, high-volume errors
Low-dollar, high-volume billing errors are frustrating for providers and health plans alike. These kinds of errors often lead to provider abrasion due to increased:
- Claim denials
- Medical record requests
- Appeals
Optum® Coding Advisor is an outreach-based solution that uses paid claim data to identify common billing errors and educate providers to improve billing behavior on future claim submissions.
Key benefits
Coding Advisor combines AI and behavioral science to deliver targeted coding insights without disrupting the provider workflow.
Identify the right providers with technology
Our advanced analytics identify providers who repeatedly submit erroneous claims and flag them for additional education.
Take a targeted approach
We deliver targeted provider messaging on potentially erroneous billing to educate providers in a collaborative, non-confrontational way.
Multi-channel engagement
Our highly trained coders contact providers via direct mail and phone to provide insight and further explain complex billing inaccuracies.
Embed education into the provider workflow
We supplement high-touch engagement with pre-submission, claim-level messaging to encourage self-correction prior to adjudication.
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.
Product information and resources
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Drive long-term behavioral change
Our proven educational system addresses losses to more than 32,000 commonly up-coded low-dollar, high-volume CPT® codes, driving positive behavioral change and more accurate billing practices.