Real Edit Intelligence

FEMALE VOICEOVER:  With traditional claim processing, the lack of interoperability between health plan and provider systems often creates challenges and inefficiencies, like manual processes to exchange data, a lack of visibility to health plan specific requirements, and variability in health plan policies. The result, avoidable claim denials that drive unnecessary rework and administrative cost for everyone. Optum Comprehensive Denial Prevention is a shift left provider education and error prevention program that changes the way we think about payment accuracy. Comprehensive Denial Prevention creates a connection between the health plan claim editor and the Provider Practice Management System, enabling billing entries or claims to be evaluated against health plan specific editing rules prior to adjudication. Providers are alerted to actionable claim errors or gaps in information in near real time and can take corrective action within their existing workflow, resulting in more accurate, complete claim submission the first time. Comprehensive Denial Prevention Managed Services will maximize the effectiveness of your denial prevention program, by directly engaging with providers to increase messaging adoption and improve claim correction rates, driving greater administrative cost savings for you and your provider network. Stop processing denials and start preventing them, with Comprehensive Denial Prevention from Optum.