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Subrogation for health plans

Identify, investigate, recover and prevent inaccurate payments linked to accident-related medical and disability expenses.

Identify incorrect payments on accident-related claims

Identifying and recovering inaccurate payments on accident-related claims while respecting member sensitivity can be challenging. Optum® Subrogation services combine pre- and post-payment processes to help you identify, recover and prevent unnecessary payment of third-party claims.

Key benefits

Our Subrogation solution automates and streamlines the identification, investigation, recovery and prevention of high-potential claims.

Score claims with our robust analytic engine

Our 2.5K rules prioritize claims by recovery potential. Machine learning models use this data to update rules and reduce false positives.

Automate claim investigation

Claims are then matched against national and state litigation and injury databases to identify liable parties and limit member outreach.

Optimize member outreach

Advanced predictive analytics determine the best channel to engage members, when needed.

Leverage legal and operational expertise

Dedicated support is provided from the start to help with case management, member outreach, legal expertise, recovery, reporting and more.

Get started today

Find out how Optum Subrogation for health plans can help your organization. 

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Product information and resources

  • PDF

     

    Brochure

    Maximize recoveries with a member-sensitive approach

    Recovering incorrect payments linked to accident-related medical or disability expenses while respecting member sensitivity can be challenging. We help you identify, investigate and recover payments. 

    Download brochure
  • PDF

     

    Brochure

    Maximize savings with Pre-Pay Subrogation services

    By combining pre- and post-pay subrogation processes, health plans can avoid unnecessary payment of third-party claims while minimizing member abrasion.

    Download brochure

Prevent and recover accident-related claim payments with our pre- and post-pay Subrogation services

Complementary solutions

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Achieve clean claims and maximize medical spend savings with our flexible, real-time claim editing software.

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Help providers reduce common billing errors with a proven education solution.

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Improve the accuracy and efficiency of your prospective payment system pricing.

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