Trends shaping the future of payment integrity
Position your health plan to respond and thrive in an environment of uncertainty. Learn about the major factors that are applying pressure to health plans nationwide as well as 4 payment integrity trends that are helping to relieve that pressure.
Key benefits
Powered by the most advanced payment accuracy engine, we've been driving the industry forward for over 25 years.
Maximize medical cost savings
Our comprehensive suite of pre- and post-payment solutions can help you achieve 8–10% medical cost savings annually.
Industry-leading expertise
Our content and analytics suites use AI and human expertise to enable more precise claim selection and proactively identify emerging trends.
Improve the provider experience
Our digital-first tools and market-leading education reduce the burden of managing billing errors and medical record requests for providers.
Shift to prevention
We work with providers to build transparency, simplify reimbursement and prevent avoidable denials with real-time error identification.
Payment Integrity solutions
Available both pre- and post-payment, our market-leading suite of solutions improves payment accuracy at every point in the claim lifecycle.
Service
Coding Advisor
Reduce common billing errors with our proven provider education: 81% of providers demonstrate positive behavioral change.
Software
Claim Pricing solutions
Improve the accuracy and efficiency of your prospective payment system pricing.
Software
Claims Edit System
Achieve clean claims and maximize medical spend savings with our flexible, real-time claim editing software.
Service
Claim Review
Prevent improper payments, reduce medical spend and minimize provider abrasion with our comprehensive suite of pre- and post-pay solutions.
Service
Coordination of Benefits
Identify and validate primary policy coverage with accurate eligibility data.
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
Article
Discover the five levels of maturity and practical tips to strengthen your plan's performance.
Article
Medical costs are rising, and health plans need solutions. See how an AI-driven, enterprise-wide approach may be the key to affordability.
![5 AI Use Cases in Payment Integrity [White Paper]](/content/dam/optum-dam/images/business/insights/man-sitting-at-desk-using-computer-1080x720.jpg)
White paper
A strategic blueprint to modernize your payment integrity program through intelligent, AI-driven health plan operations.