How accurate and complete are your submissions?
Your organization’s data, resources and needs are unique. Optum takes a customized approach to its Submission Services. We combine consultative services and technology to provide you transparency and workflow tools via a self-service portal.
It’s what sets us apart from vendors that take a one-size-fits-all approach. We can work with you and your unique data needs. We will intake, transform and submit your data to the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services (HHS) and State Managed Medicaid for your submission needs.
We can tailor it to meet your needs and match your data. Optum submissions platform offers:
- A self-service, interactive portal where you can view and track submissions by claim DOS and file — also facilitates client-driven error correction
- An easy-to-use dashboard provides summary and detail reporting
- The ability to see data error details such as value assessment of risk-adjustable services with new and unique diagnosis codes
HHS EDGE server submission services
Optum® HHS External Data Gathering Environment (EDGE) server submissions services is HITRUST risk-based, 2-year certified.
Providing end-to-end support and transparency
Optum has a proven history of successful Affordable Care Act (ACA) implementations and extensive healthcare systems knowledge. This qualifies us to lead clients to successful EDGE server submission implementations.
We submit data in the frequency required by the Department of Health and Human Services (HHS) at a minimum of quarterly, to HHS in the specified format and track those submissions and resulting HHS responses.
Optum monitors HHS business rules continually and notifies clients immediately of updates and helps clients understand so they can take the appropriate action.
Key benefits
Analytics
We can detect errors prior to submission using pre-filtering logic.
Accuracy
We submit encounter data to CMS with consistent acceptance rate over 99% and over 99% consistent acceptance rate for HHS EDGE server data.
Speed and scale
We submit data to CMS multiple times per day, within same day of receipt and we can accommodate all file sizes, no matter how big or small.
Convenience
Our self-service portal enables you to view and track submissions by claim DOS and file. Clients can drive error correction via the portal.
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