Overview

OptumInsight Retrospective Reimbursement Review and Coordination of Benefits services analyze paid-claims data to identify errors associated with improper discounts and allowances and DRGs as well as coordination of benefits due to Medicare. Suspect claims are then validated and recovered via our three-tired overpayment recoveries process. Typically, states see a return of overpayment within 60–90 days.

OptumInsight Retrospective Reimbursement Review and Coordination of Benefits services help:

• Detect errors associated with discounts and allowances
• Pinpoint coordination of benefits due to Medicare
• Resolve overpayments