Revenue management goals
Take a more assertive stance on fair and accurate payment — without labor-intensive processes to accomplish the task. We offer an array of solutions and services to help you streamline these processes and maximize reimbursement.
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OptumInsight helps you: |
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Reduce claim rejections
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Review and edit claims for billing and coding errors before submission to reduce rejections and the operational costs related to resubmissions. Check claims against rules that apply to specific payer contracts before submission.
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Discover missed revenue
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Automatically detect missing procedures — the system alerts you to bills where procedure codes appear without codes that are normally related. Differentiate codes and make informed decisions as to what code best fits, for appropriate reimbursement.
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Identify underpayments
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Improve cash flow with automated variance detection that compares payments against contractual terms. Streamline efficiency by reducing labor-intensive manual reviews.
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Ensure regulatory compliance
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Stay current with government and private payer regulations to reduce compliance risks and curb claim rejections, resulting in more efficient claim processing and better revenue capture rates due to increased accuracy.
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Directly connect with payers
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Directly link your practice with payers through HIPAA-compliant electronic data interchange (EDI) without the need for third-party clearinghouses. Reduce transaction costs and accelerate the speed of transactions.
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Manage payer contracts
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Centrally store all payer contracts. Allow enterprise-wide access to improve workflow when verifying billing processes and when evaluating terms for renewal. Model the impact of promised terms and rates before signing contracts. Review the impact of key variables and identify specific elements of underperforming contracts.
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Reduce payer rejections
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Automate claim error checking — validates claims before submission to reduce rejection rates. Simplify trading partner transactions with intelligent processing that automatically routes transactions based on business rules.
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Improve patient collection
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Automate patient billing and streamline the receipt of patient payments to improve patient collection, speed recovery of amounts owed and reduce patient billing costs.
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