Prospective Payment System Maintenance Overview

Regulatory updates

PPS reimbursement requires ongoing regulatory updates. OptumInsight evaluates ways to streamline the regulatory update process to reduce occurrences of inaccurate payments and to maximize staffing and IT resources.

Maximize Your PPS Efforts with:

• Ongoing education and training sessions
• Provider claims audits and analysis
• Technical support
• Access to PPS information and regulatory resources
• Update management services

Training and Education

Implementation won’t be truly successful unless your providers are properly educated about PPS and understand its reimbursement processes. OptumInsight can help design programs to educate providers to decrease the time payers spend reconciling payments.

Solutions

Many payers underestimate the infrastructure that is needed to implement and maintain an efficient PPS reimbursement program. OptumInsight can evaluate existing infrastructure and make recommendations for solutions that will streamlines processes.