Consumer Code Manager (CCM) Overview

CCM is a multi-use, ready-made, simple-to-use, cost-saving solution::

• Improves transparency by aligning straightforward descriptions with costs and dates of service seen on EOBs
• Increases consumer health literacy by providing easy-to-understand descriptions of health procedures, tests and diagnoses
• Enhances efforts to reduce fraud and abuse by showing members what they are paying for
• Adds high value for minimal investment by mapping to frequently used health information sources: CPT, HCPCS, ICD-9-CM diagnosis and revenue codes
• Has been consumer tested, doctor reviewed and coder verified

The dialogue around health care reform has had its intended effect: Consumers today are engaged in their health care. There is energy and a zest for understanding. Plans and providers are implementing unprecedented levels of electronic information sharing. Health literacy is now an industry buzzword.

Bring Intelligence and Relevance to Consumer Information

Many of the tools that health plans offer to consumers obtain information from administrative codes. The codes provide ready-made links between costs, services and diagnoses. But consumers do not understand the codes or the medical jargon often used. They want to know the bottom line: What are they paying for and how much are they being charged? Consumer Code Manager offers a solution that improves both transparency and health literacy—in one package.

Reduce Administrative Burdens and Costs

The National Health Care Anti-fraud Association estimates that in 2008, inappropriate billings for health care accounted for $68 billion. Medicare’s beneficiary web site notes that consumers are the crucial link in determining whether a billed item is correct. Yet consumers complain that they can’t decipher their EOBs. Consumer Code Manager can help bridge the gap in understanding. When consumers can truly identify billed items, they are far more likely to investigate when something looks wrong. This could translate into substantial savings for a health plan.

CCM descriptions can enhance products and services with minimal start-up effort. Integrating CCM into EOB and PHR systems can be fast: Some clients have set up CCM in less than a week. And once the connections are in place, OptumInsight handles a regular schedule of updates.

Enhance Member Satisfaction

This valuable, easily implemented solution has immediate benefits for health plans and consumers alike. Consumer Code Manager seamlessly integrates with existing systems, helping health plans differentiate themselves with the quality and type of member services provided. Consumers don’t need to change their behavior to get informative, positive results immediately. Instead of being overwhelmed by a flood of health information, consumers easily sift through everyday language to get straight to the heart of their data.

Consumer Code Manager addresses the heart of the consumer experience.