Skip to main content

Solution suite

Submission Services

We provide end-to-end management of submissions, direct errors and remediation. Insights promote continual improvement to maximize accuracy.

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

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.

Support

Consultative client support team to assist with maximizing submission data accuracy, throughput and acceptance

Industry insights

Delivering Care Continuity for Specialty and Infusion Therapy

Article

Our care doesn’t stop, no matter where your patients are

Optum helps providers keep patients on therapy during travel, relocation or disruption through coordinated, nationwide infusion and specialty pharmacy support.

Top 5 Ways Optum Rx Is Putting AI Into Action

Article

Top 5 ways Optum Rx is putting AI into action

See how we’re using AI to make pharmacy care faster, more personalized and proactive.

Real-Time Transparency Will Transform Healthcare [Report]

Report

Real-time transparency will transform healthcare

Learn how provider organizations can evaluate and implement new AI-powered claim technologies that lower costs and administrative burden.

Optum is your trusted partner when it comes to submissions

Product information and resources