Optum Real for Dental

NARRATOR: Today's revenue cycle is complex, time-consuming, and often frustrating. Providers lack transparency into updated payer information, such as patient eligibility, coverage, and payment policies, until after they've seen a patient and submitted a claim. This leads to 15% of dental claims being denied, resulting in payment delays, provider burnout, and patient frustration. Today, Optum Real for Dental is enhancing the revenue cycle by exchanging patient visit, claim, and payment data in real time. So providers get the information they need when they need it. Let's look at an example.

At Amy's last dental checkup, her provider realized her tooth was cracked and needed restorative procedures and a crown. When Amy returns to the dentist's office to receive her restorative procedures, the office enters Amy's information and the planned procedure code for a crown on tooth number 32 to submit a pre-care estimate. Optum Real provides a likely approval status, meaning that no eligibility, COB, or non-participating denial reasons were identified. It also gives insight into an estimation of how much Amy's insurance will cover, and how much she'll owe out of pocket before her procedure.

After Amy receives her restorative procedure, the office will submit the claim and collect her payment before she leaves the office, and she is scheduled for her crown seating in a couple of weeks. The result? Improved transparency, fewer denials, quicker payments, and a better experience for dental providers and their patients. Together, we're helping make the healthcare system work better for everyone.